Organization Active NPI

Wenatchee Valley Hospital

  • Rural Health Clinic/Center
  • Omak, WA
National Provider Identifier
1992042709
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
WENATCHEE VALLEY HOSPITAL
Practice address
916 Koala Ave
Omak, WA 98841-9576
Phone
(509) 826-1800
NPI assigned
Jan 14, 2013
Last updated
Mar 17, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
WENATCHEE VALLEY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Authorized official

Name
Mr. Glenn Adams
Title
Coo
Phone
(509) 663-8711

Specialties & licenses 1

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

Addresses

Primary practice location

916 Koala Ave
Omak, WA 98841-9576

Mailing address

PO Box 361
Wenatchee, WA 98807-0361
Phone (509) 663-8711

Other identifiers 1

IdentifierTypeStateIssuer
7070329MedicaidWA

Other names 1

  • Confluence Health Omak Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D0661558Confluence Health - Omak Campus916 Koala Ave, Omak, WA 98841ComplianceApr 4, 2028
50D2285334Confluence Health - Omak Campus916 Koala Dr, Omak, WA 98841Provider-performed microscopyApr 4, 2028

National Provider Directory

National Provider Directory
Part of
Wenatchee Valley Hospital

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jul 1, 2023 Change of OwnershipThis provider was the seller Confluence Health Omak ClinicCCN 503935, WA, NPI 1760102545

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": "1358121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647475200000",
    "number": "1992042709",
    "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": "509-663-8711",
            "fax_number": "509-664-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 KOALA AVE",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419576",
            "telephone_number": "509-826-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WENATCHEE VALLEY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WENATCHEE VALLEY HOSPITAL",
        "enumeration_date": "2013-01-14",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "509-663-8711",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7070329",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Confluence Health Omak",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Confluence Health Omak",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Omak, WA

Sources for this page

Verify at the official NPI Registry.