Provider Demographics
NPI:1275990764
Name:SPECTRUM HEALTH SYSTEMS INC.
Entity Type:Organization
Organization Name:SPECTRUM HEALTH SYSTEMS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EASTERN WASHINGTON REGIONAL DIRECTO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:HURT-MORAN
Authorized Official - Suffix:
Authorized Official - Credentials:CHEMICAL DEPENDENCY
Authorized Official - Phone:509-863-4233
Mailing Address - Street 1:427 W 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2611
Mailing Address - Country:US
Mailing Address - Phone:509-863-4233
Mailing Address - Fax:
Practice Address - Street 1:202 W YAKIMA AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3473
Practice Address - Country:US
Practice Address - Phone:509-863-4233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health