Columbia Basin Health Association

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

COLUMBIA BASIN HEALTH ASSOCIATION

Doing business as

Columbia Basin Health Association

Practice address

475 N 14TH Ave
Othello, WA 99344-1226

Phone

(509) 488-6644

Fax

(509) 488-9939

NPI assigned

Apr 24, 2007

Last updated

May 6, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nieves Gomez

Title

Ceo

Phone

(509) 488-5256

Specialties & licenses 2

Addresses

Other identifiers 7

Other names 1

• Columbia Basin Health Association Doing business as

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651795200000",
    "number": "1972721710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E COLUMBIA ST",
            "city": "OTHELLO",
            "state": "WA",
            "postal_code": "993441846",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 N 14TH AVE",
            "city": "OTHELLO",
            "state": "WA",
            "postal_code": "993441226",
            "telephone_number": "509-488-6644",
            "fax_number": "509-488-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA BASIN HEALTH ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "NIEVES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-488-5256"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "50D0640014",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UGS MDC DSHS CROSSOVER",
            "identifier": "7107675",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7406119",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAKE CHARGE #",
            "identifier": "7900624",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7121585",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT L&I #",
            "identifier": "0035900",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS #",
            "identifier": "08908941",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbia Basin Health Association",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Columbia Basin Health Association",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Columbia Basin Health Association
• Columbia Basin Health Association
• Columbia Basin Health Association
• Columbia Basin Health Association
• Columbia Basin Health Association (Othello Dental Center)
• Columbia Basin Health Association
• Annie M Coronado, PA
• County of Adams (Adams County Integrated Health Care Services)
• County of Adams (Adams County Health Department)
• County of Adams (Adams County Integrated Health Care Services)

• Federally Qualified Health Center (FQHC) in Othello, WA
• Providers in Othello, WA by specialty
• Federally Qualified Health Center (FQHC) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.