Provider Demographics
NPI:1669647053
Name:NEW HEALTH PROGRAM ASSOCIATION
Entity Type:Organization
Organization Name:NEW HEALTH PROGRAM ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER CREDENTIALING SPECI
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ESTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-935-6001
Mailing Address - Street 1:PO BOX 808
Mailing Address - Street 2:
Mailing Address - City:CHEWELAH
Mailing Address - State:WA
Mailing Address - Zip Code:99109-0808
Mailing Address - Country:US
Mailing Address - Phone:509-935-6001
Mailing Address - Fax:509-935-4196
Practice Address - Street 1:509 E MAIN AVE
Practice Address - Street 2:
Practice Address - City:CHEWELAH
Practice Address - State:WA
Practice Address - Zip Code:99109-8964
Practice Address - Country:US
Practice Address - Phone:509-935-6001
Practice Address - Fax:509-935-4196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAJ 600317870261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACE9078OtherRAILROAD MEDICARE
WACE9078OtherRAILROAD MEDICARE