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Family Health Centers

Organization Active NPI Federally Qualified Health Center (FQHC) · Bridgeport, WA

NPI 1609584697 · NPPES record last updated Nov 9, 2022

Key facts

NPI
1609584697
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
FAMILY HEALTH CENTERS
Practice address
1400 Tacoma Avenue
Bridgeport, WA 98813
Phone
(509) 422-5700
Fax
(509) 422-7680
NPI assigned
Nov 9, 2022
Organization subpart
No

Authorized official

Name
Mr. Jesus Hernandez
Title
Ceo
Phone
(509) 422-7601

Corporate family (same tax ID) 22

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

National Provider Directory

Tax ID family
Family Health Centers (23 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

1400 Tacoma Avenue
Bridgeport, WA 98813

Mailing address

PO Box 1340
Okanogan, WA 98840-1340
Phone (509) 422-7674

Other identifiers

IdentifierTypeStateIssuer
7060643MedicaidWA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 9, 2022.

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1609584697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1340",
            "city": "OKANOGAN",
            "state": "WA",
            "postal_code": "988401340",
            "telephone_number": "509-422-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 TACOMA AVENUE",
            "city": "BRIDGEPORT",
            "state": "WA",
            "postal_code": "98813",
            "telephone_number": "509-422-5700",
            "fax_number": "509-422-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-04",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JESUS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-422-7601",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7060643",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WA

All providers in Bridgeport, WA · Federally Qualified Health Center (FQHC) in Washington

Sources for this page

Verify at the official NPI Registry.