Provider Demographics
NPI:1710094818
Name:VISTA FAMILY HEALTH INC
Entity Type:Organization
Organization Name:VISTA FAMILY HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:COLEEN
Authorized Official - Last Name:FLESHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-735-2325
Mailing Address - Street 1:7201 W GRANDRIDGE BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-6709
Mailing Address - Country:US
Mailing Address - Phone:509-735-2325
Mailing Address - Fax:509-735-3222
Practice Address - Street 1:7201 W GRANDRIDGE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-6709
Practice Address - Country:US
Practice Address - Phone:509-735-2325
Practice Address - Fax:509-735-3222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601426358207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty