Chelan-Douglas Health District
Organization Active NPI Public Health or Welfare Agency · East Wenatchee, WA
NPI 1730278755 · NPPES record last updated Dec 7, 2010
Key facts
- NPI
- 1730278755
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- License
- 60005350554 (WA)
- Legal business name
- CHELAN-DOUGLAS HEALTH DISTRICT
- Practice address
- 200 Valley Mall Parkway
East Wenatchee, WA 98802 - Phone
- (509) 886-6400
- Fax
- (509) 886-6478
- NPI assigned
- Oct 11, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Barry W Kling
- Title
- Administrator
- Phone
- (509) 886-6480
Practitioners 1
-
Francis JV Collins, MD, DDS
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 50D2129440 | Chelan Douglas Health District Wic | Certificate of waiver | Apr 4, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040309001223 | WA | Part B Supplier - Mass Immunization (Roster Biller Only) | 0840188918 | Practice locations: East Wenatchee, WA |
National Provider Directory
Locations
200 Valley Mall Pkwy
East Wenatchee, WA 98802
Phone (509) 664-5306
316 Washington St
Wenatchee, WA 98801
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | 60005350554 | WA | Yes |
Addresses
Primary practice location
200 Valley Mall Parkway
East Wenatchee, WA 98802
Mailing address
200 Valley Mall Parkway
East Wenatchee, WA 98802
Phone (509) 886-6400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7311004 | Medicaid | WA | |
| 7401185 | Medicaid | WA | |
| 7403538 | Medicaid | WA |
Other providers in East Wenatchee, WA
- Ronald W Byquist
- Can DO Kids Therapy Services
- Central Washington Health Services Association
- Giovanni Cervantes
- Justine Ann Champion
- Michael C Civile
- Kevin Clive
- Cydne Cochran
- Angel Collins
- Columbia Valley Community Health
All providers in East Wenatchee, WA · Public Health or Welfare Agency in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2010. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.