Provider Demographics
NPI:1558941781
Name:COLUMBIA BASIN PSYCHIATRIC SOLUTIONS PLLC
Entity Type:Organization
Organization Name:COLUMBIA BASIN PSYCHIATRIC SOLUTIONS PLLC
Other - Org Name:COLUMBIA BASIN PSYCHIATRIC SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HAMEL
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, ARNP, PMHNP-BC
Authorized Official - Phone:509-300-1203
Mailing Address - Street 1:8108 W GRANDRIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7157
Mailing Address - Country:US
Mailing Address - Phone:509-521-4134
Mailing Address - Fax:
Practice Address - Street 1:8108 W GRANDRIDGE BLVD
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7157
Practice Address - Country:US
Practice Address - Phone:509-521-4134
Practice Address - Fax:509-420-9943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-12
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2097569Medicaid
WA2144455Medicaid