Provider Demographics
NPI:1508911645
Name:OKANOGAN DOUGLAS COUNTY HOSPITAL DIST 1
Entity Type:Organization
Organization Name:OKANOGAN DOUGLAS COUNTY HOSPITAL DIST 1
Other - Org Name:ADVANTAGE D.M.E.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-689-2517
Mailing Address - Street 1:PO BOX 520
Mailing Address - Street 2:537 WEST MAIN
Mailing Address - City:BREWSTER
Mailing Address - State:WA
Mailing Address - Zip Code:98812-0520
Mailing Address - Country:US
Mailing Address - Phone:509-689-2517
Mailing Address - Fax:
Practice Address - Street 1:537 WEST MAIN
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:WA
Practice Address - Zip Code:98812
Practice Address - Country:US
Practice Address - Phone:509-689-2510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OKANOGAN DOUGLAS COUNTY HOSPITAL DIST 1
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-25
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAH-023282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3867270002Medicare NSC
WA3867270002Medicare Oscar/Certification