NPIMap

Organization Active NPI

Central Washington Health Services Association

Doing business as Confluence Health Omak Clinic

  • Rural Health Clinic/Center
  • Omak, WA
National Provider Identifier
1760102545
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION
Doing business as
Confluence Health Omak Clinic
Practice address
916 Koala Dr
Omak, WA 98841-9759
Phone
(509) 826-1800
NPI assigned
Aug 31, 2022
Last updated
Mar 12, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Andrew Jones, MD
Title
Ceo
Phone
(509) 662-1511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

916 Koala Dr
Omak, WA 98841-9759

Mailing address

PO Box 361
Wenatchee, WA 98807-0361
Phone (509) 662-1511

Other names 1

  • CONFLUENCE HEALTH OMAK CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230712002053 WA Part A Provider - Rural Health Clinic 4880504596 Practice locations: Omak, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760102545. Details of each certification follow.

Rural health clinic certification: CCN 503935

Legal name
CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION
Doing business as
CONFLUENCE HEALTH OMAK CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 1, 2023
Last certification
Aug 26, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1966 in WA
Enrollment address
916 Koala Dr
Omak, WA 98841-9759

Other NPIs with the same Medicare PAC ID 24

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 24

National Provider Directory

National Provider Directory
Tax ID family
Confluence Health24 organizations share this tax ID, including this one
Part of
Confluence Health

Other organizations with this tax ID 23

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

View all 23

Ownership & related parties

All disclosed owners & managing parties 19

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jeffrey Neher Individual Corporate DirectorBoard of Directors Sep 1, 2024
Lauren Weber Individual Corporate Director Dec 1, 2023
Jennifer E Jorgensen Individual Corporate DirectorBoard of Directors Jul 1, 2023
David Balcom Individual Corporate DirectorBoard of Directors Jul 1, 2023
Christina M Cox Individual Corporate Director Jul 1, 2023
W-2 Managing Employee Jul 1, 2023
Vicky Scharlau Individual Corporate DirectorBoard of Directors Jul 1, 2023
Andrew D Jones Individual Corporate OfficerCeo Jul 1, 2023
Corporate DirectorCeo Jul 1, 2023
W-2 Managing Employee Jul 1, 2023
Eric J Caldwell Individual Corporate OfficerVP Finance Dec 16, 2024
Corinne Bautista Individual Corporate DirectorBoard of Director Jul 1, 2023
Central Washington Health Services Association Organization, Wenatchee, WA Corporation, Non-profit Operational/Managerial Control Jul 13, 2013
Daniel J Kerr Individual Corporate Director Aug 1, 2023
Juan Diaz Individual Corporate DirectorBoard of Director May 1, 2026
Sri Krishnan Individual Corporate DirectorBoard of Director May 1, 2026
Brianna Keith Individual Corporate Director Mar 1, 2024
W-2 Managing Employee Mar 1, 2024
Luther Thompson Individual Corporate DirectorBoard of Directors Apr 1, 2024
Dianne Probach Individual Corporate OfficerBoard of Director May 1, 2026
Abraham James Sorom Individual Corporate Director Jul 1, 2023
Garn Christensen Individual Corporate DirectorBoard of Directors Jul 1, 2023
Vanessa Gutierrez Individual Corporate DirectorBoard of Directors Jul 1, 2023

Owners & managing parties with NPI records 29

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 29

All facility ownership & control disclosures 11

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Central Washington Health ServicesWenatchee, WA, CCN 507029 Home health agency Operational/Managerial Control Jul 21, 2013
Confluence Health Tonasket ClinicTonasket, WA, CCN 503932 Rural health clinic Operational/Managerial Control Jul 13, 2023
Confluence Health Oroville ClinicOroville, WA, CCN 503936 Rural health clinic Operational/Managerial Control Jul 13, 2013
Confluence Health Moses Lake ClinicMoses Lake, WA, CCN 503934 Rural health clinic Operational/Managerial Control Jul 13, 2023
Confluence Health Wenatchee ClinicWenatchee, WA, CCN 503938 Rural health clinic Operational/Managerial Control Jul 1, 2013
Confluence Health Ephrata ClinicEphrata, WA, CCN 503927 Rural health clinic Operational/Managerial Control Jul 1, 2023
Confluence Health Waterville ClinicWaterville, WA, CCN 503937 Rural health clinic Operational/Managerial Control Jul 1, 2023
Confluence Health Brewster ClinicBrewster, WA, CCN 503920 Rural health clinic Operational/Managerial Control Jul 1, 2023
Confluence Health Cashmere ClinicCashmere, WA, CCN 503933 Rural health clinic Operational/Managerial Control Jul 13, 2013
Confluence Health E Wenatchee ClinicE Wenatchee, WA, CCN 503931 Rural health clinic Operational/Managerial Control Jul 1, 2023
Confluence Health Royal City ClinicRoyal City, WA, CCN 503854 Rural health clinic Operational/Managerial Control Jul 13, 2013

Owned or controlled facilities with NPI records 11

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 11

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Change-of-ownership history 1

DateEventCounterparty
Jul 1, 2023 Change of OwnershipThis provider was the buyer Confluence Health OmakCCN 508512, WA, NPI 1992042709

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1760102545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 361",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988070361",
            "telephone_number": "509-662-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 KOALA DR",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419759",
            "telephone_number": "509-826-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION",
        "enumeration_date": "2022-08-31",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-662-1511",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CONFLUENCE HEALTH OMAK CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CONFLUENCE HEALTH OMAK CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omak, WA

Sources for this page

Verify at the official NPI Registry.