Family Health Centers
Organization Active NPI Federally Qualified Health Center (FQHC) · Okanogan, WA
NPI 1609804392 · NPPES record last updated Jan 19, 2021
Key facts
- NPI
- 1609804392
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- License
- 600625131 (WA)
- Legal business name
- FAMILY HEALTH CENTERS
- Practice address
- 716 First Avenue South
Okanogan, WA 98840-9679 - Phone
- (509) 422-5700
- Fax
- (509) 422-7680
- NPI assigned
- Jun 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Jesus Hernandez
- Title
- Interm Ceo
- Phone
- (509) 422-7601
Owned or controlled facilities with NPI records 2
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 5
Practitioners 89
-
Blue E Bradley, CNM, ARNP
-
Kevan Christina Coffey, ARNP
-
Erin Cooley, MD
-
Amanda Kate Davis, ARNP
-
Victoria Malloch Desalvo, ARNP
-
Waldemar Lugo-Alvarez, M.D.
-
Rebecka S Maynard, ARNP
-
Emily R. Miller, M.D.
-
Joshua Monson, MD
-
Briana Pardo, PMHNP
-
Katelyn Ann Schumacher, MD, MPH
-
John T Spannuth, FNP
-
James G Wallace Jr., M.D.
-
Nicole Werner, DO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Family Health Centers |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 1, 2014 Jan 1, 2014 |
| Family Health Centers Twisp |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
May 1, 2015 May 1, 2015 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040301000378 | WA | Part B Supplier - Clinic/Group Practice | 9739076217 |
Receives reassigned benefits from 52 practitioners 1 other NPI on this enrollment Practice locations: Bridgeport, WA; Winthrop, WA; Twisp, WA; Tonasket, WA; Omak, WA; Okanogan, WA; Brewster, WA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | 600625131 | WA | Yes |
Addresses
Primary practice location
716 First Avenue South
Okanogan, WA 98840-9679
Mailing address
PO Box 1340
Okanogan, WA 98840-1340
Phone (509) 422-5700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C03341 | Other | WA | MEDICARE PTAN |
| 501837 | Other | WA | PTAN |
| 501968 | Other | WA | MEDICARE PTAN |
| 1306005715 | Other | WA | MEDICARE |
| 1184883449 | Other | WA | MEDICARE |
| 1497176390 | Other | WA | MEDICARE |
| 1609804392 | Other | WA | MEDICARE |
| 1821340092 | Other | WA | MEDICARE |
| 501949 | Other | WA | MEDICARE PTAN |
| 7060643 | Medicaid | WA | |
| G000354600 | Other | WA | MEDICARE PTAN |
| 1629237482 | Other | WA | MEDICARE |
| 501836 | Other | WA | PTAN |
| 801838 | Other | WA | PTAN |
Other names
- OKANOGAN FARM WORKERS CLINIC
Other providers in Okanogan, WA
- Whitney Cowan
- Robert M Dillard
- Alexandria Mae Egusquiza
- Family Health Centers
- Family Health Centers
- Family Health Centers
- Family Health Centers
- Family Health Centers
- Family Health Centers
- Family Health Centers Dental
All providers in Okanogan, WA · Federally Qualified Health Center (FQHC) in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.