NPIMap

Organization Active NPI

Public Hospital District 1 of Klickitat Co

Doing business as Klickitat Valley Health

  • Community/Retail Pharmacy
  • Goldendale, WA
National Provider Identifier
1558828467
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PUBLIC HOSPITAL DISTRICT 1 OF KLICKITAT CO
Doing business as
Klickitat Valley Health
Practice address
310 S Roosevelt
Goldendale, WA 98620
Phone
(509) 773-4022
Fax
(509) 773-1036
NPI assigned
Feb 27, 2019
Last updated
Feb 27, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
PUBLIC HOSPITAL DISTRICT 1 OF KLICKITAT COAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Leslie Hiebert
Title
Ceo
Phone
(509) 773-1002

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

310 S Roosevelt
Goldendale, WA 98620

Mailing address

310 S Roosevelt
Goldendale, WA 98620
Phone (509) 773-4022

Other names 1

  • Klickitat Valley Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Pracitice Clinic7 organizations share this tax ID, including this one
Part of
Family Pracitice Clinic

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551225600000",
    "number": "1558828467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 S ROOSEVELT",
            "city": "GOLDENDALE",
            "state": "WA",
            "postal_code": "98620",
            "telephone_number": "509-773-4022",
            "fax_number": "509-773-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S ROOSEVELT",
            "city": "GOLDENDALE",
            "state": "WA",
            "postal_code": "98620",
            "telephone_number": "509-773-4022",
            "fax_number": "509-773-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DISTRICT 1 OF KLICKITAT CO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUBLIC HOSPITAL DISTRICT 1 OF KLICKITAT CO",
        "enumeration_date": "2019-02-27",
        "last_updated": "2019-02-27",
        "status": "A",
        "authorized_official_last_name": "HIEBERT",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-773-1002"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Klickitat Valley Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goldendale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.