Columbia Basin Health Association
Organization Active NPI Pharmacist · Connell, WA
NPI 1629311436 · NPPES record last updated Jun 5, 2025
Key facts
- NPI
- 1629311436
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacist 183500000X
- License
- CF60349261 (WA)
- Legal business name
- COLUMBIA BASIN HEALTH ASSOCIATION
- Practice address
- 1051 Columbia Avenue
Connell, WA 99326-8702 - Phone
- (509) 234-0866
- Fax
- (509) 488-9939
- NPI assigned
- Mar 29, 2013
- Organization subpart
- No
Authorized official
- Name
- Nieves Gomez
- Title
- Ceo
- Phone
- (509) 488-5256
Owned or controlled facilities with NPI records 2
Other NPIs on the same Medicare enrollment 5
Other NPIs with the same Medicare PAC ID 9
Corporate family (same tax ID) 16
Practitioners 53
-
Luis Carlos Alcalde, PHYSICIAN ASSISTANT
-
Annie M Coronado, PA
-
Jordan Earl, OD
-
Adam Dale Good, OD
-
Jarom Daniel Hayward, PAC
-
Charles Ibeziako, MD
-
Melissa Alvarez, PA-C, PHARMD
-
Sarah Dinneen Anderson, ARNP
-
Trent Z Armstrong, ARNP
-
Alaa Atfeh, M.D.
-
Sarah Bannon, ARNP
-
Miguel Blas-Matus, PA-C
-
Jason M Bleazard, O.D.
-
Kelsey Campbell, PA-C
-
Tamara J Campbell, ARNP
-
Maria J Castillo, ARNP
-
Stephanie Ann Easton, FNP
-
Bashar Elali, M.D.
-
Elsie Aileen Garza, MSW
-
Veniel Garza, DO
-
Joeun Gilland, ARNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WA
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Columbia Basin Health Association |
Federally qualified health center | Operational/Managerial Control (100%) | Mar 18, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040209000250 | WA | Part B Supplier - Clinic/Group Practice | 4486564309 |
Receives reassigned benefits from 95 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Connell, WA; Mattawa, WA; Othello, WA; Pasco, WA; Royal City, WA |
| O20150511001897 | WA | DME Supplier - Pharmacy | 4486564309 | Practice locations: Connell, WA |
National Provider Directory
- Tax ID family
- Columbia Basin Health Association
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | CF60349261 | WA | Yes |
| Durable Medical Equipment & Medical Supplies | 332B00000X | CF60349261 | WA |
Addresses
Primary practice location
1051 Columbia Avenue
Connell, WA 99326-8702
Mailing address
1515 E Columbia St
Othello, WA 99344-1846
Phone (509) 488-5256
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4935245 | Other | WA | NABP |
Other names
- Connell Pharmacy
Other providers in Connell, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2025. 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.