Family Health Centers
Organization Active NPI Federally Qualified Health Center (FQHC) · Brewster, WA
NPI 1629237482 · NPPES record last updated Jan 19, 2021
Key facts
- NPI
- 1629237482
- 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
- 525 W Jay
Brewster, WA 98812 - Phone
- (509) 422-5700
- Fax
- (509) 422-7680
- NPI assigned
- Jun 6, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- FAMILY HEALTH CENTERS
Authorized official
- Name
- Jesus Hernandez
- Title
- Ceo
- Phone
- (509) 422-5700
Owned or controlled facilities with NPI records 2
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 22
Member organizations 2
Practitioners 31
-
Blue E Bradley, CNM, ARNP
-
Kevan Christina Coffey, ARNP
-
Erin Cooley, MD
-
Amanda Kate Davis, ARNP
-
Victoria Malloch Desalvo, ARNP
-
Jennifer England, MD
-
Waldemar Lugo-Alvarez, M.D.
-
Rebecka S Maynard, ARNP
-
Emily R. Miller, M.D.
-
Joshua Monson, MD
-
Briana Pardo, PMHNP
-
Daisy Sajuan, NP-C
-
Katelyn Ann Schumacher, MD, MPH
-
John T Spannuth, FNP
-
Michael L Tuggy, MD
-
Erin A Vander Stoep, PA-C
-
James G Wallace Jr., M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Federally qualified health center certification: CCN 501838
- Legal name
- FAMILY HEALTH CENTERS
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jul 1, 1995
- Last certification
- Jul 1, 1995
- Ownership / control type
- For profit – partnership
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 21, 1985 in WA
- Enrollment address
- 525 West Jay Street
Brewster, WA 98812-3403
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Charlene a Burns |
Other |
Apr 1, 2019 | |
| George Thornton |
Corporate Director | Mar 1, 2016 | |
| Caludia Lee Miller |
Other |
Jun 1, 2018 | |
| Teresa Trejo |
Other | May 1, 2017 | |
| Jose Luna |
Corporate Director | Jun 1, 2018 | |
| Ayde Garza |
Corporate Director | Jun 1, 2014 | |
| Cesilia Brooks |
Corporate Director | Dec 1, 2015 | |
| Jesus Hernandez |
Contracted Managing Employee |
Mar 14, 2016 | 100% |
| Corporate Director |
Mar 14, 2016 | 100% | |
| W-2 Managing Employee |
Mar 14, 2016 | 100% | |
| Operational/Managerial Control |
Mar 14, 2016 | 100% | |
| Parker Parsons |
Corporate Director | Dec 12, 2008 | |
| Peter Morgan |
Other |
Jun 28, 2011 | |
| Charles Root |
Other |
Dec 12, 2008 |
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 |
|---|---|---|---|---|
| O20081211000837 | WA | Part a Provider - Federally Qualified Health Center (FQHC) | 9739076217 | Practice locations: Brewster, WA |
National Provider Directory
- Tax ID family
- Family Health Centers
- Part of
- Family Health Centers
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | 600625131 | WA | Yes |
Addresses
Primary practice location
525 W Jay
Brewster, WA 98812
Mailing address
PO Box 1340
Okanogan, WA 98840
Phone (509) 422-5700
Other names
- OKANOGAN FARM WORKER CLINIC
Other providers in Brewster, WA
- Eagle Rock Physical Therapy, PS
- Jean Ann Ekvall
- Amy E Ellingson
- Joshua Lee Emmil
- Family Health Centers
- Family Health Centers
- Family Health Centers
- Family Health Centers
- Diana Forrest
- Barbara Gayle
All providers in Brewster, 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.