Provider Demographics
NPI:1710240924
Name:WHITMAN COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:WHITMAN COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPARTMENT HEAD
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:509-397-6280
Mailing Address - Street 1:310 N MAIN ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:COLFAX
Mailing Address - State:WA
Mailing Address - Zip Code:99111-1848
Mailing Address - Country:US
Mailing Address - Phone:509-397-6280
Mailing Address - Fax:509-397-6239
Practice Address - Street 1:1205 SE PROFESSIONAL MALL BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5423
Practice Address - Country:US
Practice Address - Phone:509-332-6752
Practice Address - Fax:509-334-4517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5901152Medicaid
WA7401433Medicaid
WA5901145Medicaid
WA7071137Medicaid
WA5901467Medicaid