NPIMap

Organization Active NPI

Okanogan Douglas County Hospital Dist 1

Doing business as Three Rivers Family Medicine

  • Rural Health Clinic/Center
  • Brewster, WA
National Provider Identifier
1891347696
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
OKANOGAN DOUGLAS COUNTY HOSPITAL DIST 1
Doing business as
Three Rivers Family Medicine
Practice address
415 Hospital Way
Brewster, WA 98812
Phone
(509) 689-3749
NPI assigned
Jul 11, 2019
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
OKANOGAN DOUGLAS COUNTY HOSPITAL DIST 1As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Jamie Marie Boyer
Title
Director
Phone
(509) 689-2517

Specialties & licenses 1

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

Addresses

Primary practice location

415 Hospital Way
Brewster, WA 98812

Mailing address

PO Box 577
Brewster, WA 98812-0577
Phone (509) 689-2517

Other names 1

  • Three Rivers Family Medicine Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jboyer@trhospital.net Direct OKANOGAN DOUGLAS DISTRICT HOSPITAL #1

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040219000122 WA Part B Supplier - Clinic/Group Practice 7810882792 Receives reassigned benefits from 253 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brewster, WA
O20190925001756 WA Part A Provider - Rural Health Clinic 7810882792 Practice locations: Brewster, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891347696. Details of each certification follow.

Rural health clinic certification: CCN 508589

Legal name
OKANOGAN DOUGLAS COUNTY HOSPITAL DIST 1
Doing business as
THREE RIVERS FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 9, 2020
Last certification
Apr 9, 2020
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Enrollment address
415 Hospital Way
Brewster, WA 98812-0577
Related CCNs
501324

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Coulee Clinic16 organizations share this tax ID, including this one
Part of
Coulee Clinic

Other organizations with this tax ID 15

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

View all 15

Interoperability endpoints

  • Direct secure messaging: jboyer@trhospital.net

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Antone Eek Individual Corporate OfficerChief Financial Officer Interim Aug 11, 2025
W-2 Managing EmployeeInterim Chief Financial Officer Aug 11, 2025
James S Graham Individual Corporate DirectorCeo May 12, 2014
David Garcia Individual Corporate DirectorBoard Member Apr 29, 2020
Tracy D Shrable Individual Corporate DirectorBoard Member Nov 22, 2010
Jamie Boyer Individual Corporate OfficerChief Operating Officer Jan 1, 2024
W-2 Managing EmployeeClinic Manager Jun 19, 2017
Mike Pruett Individual Corporate DirectorBoard Member Jan 28, 2013
Okanogan Douglas County Hospital Dist 1 Organization, Brewster, WA Other Oct 1, 2019
Cherri Thomas Individual Corporate DirectorBoard Member Jan 1, 2014
Leslie G McNamara Individual Corporate DirectorBoard Member Aug 29, 2017

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 76

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 76

NPI Registry JSON

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1891347696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 577",
            "city": "BREWSTER",
            "state": "WA",
            "postal_code": "988120577",
            "telephone_number": "509-689-2517",
            "fax_number": "509-689-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 HOSPITAL WAY",
            "city": "BREWSTER",
            "state": "WA",
            "postal_code": "98812",
            "telephone_number": "509-689-3749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKANOGAN DOUGLAS COUNTY HOSPITAL DIST 1",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OKANOGAN DOUGLAS COUNTY HOSPITAL DIST 1",
        "enumeration_date": "2019-07-11",
        "last_updated": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "BOYER",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "509-689-2517"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jboyer@trhospital.net",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "OKANOGAN DOUGLAS DISTRICT HOSPITAL #1",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "415 Hospital Way",
            "city": "BREWSTER",
            "state": "WA",
            "country_code": "US",
            "postal_code": "98812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Three Rivers Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brewster, WA

Sources for this page

Verify at the official NPI Registry.