Provider Demographics
NPI:1861490633
Name:SKAMANIA COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:SKAMANIA COUNTY HOSPITAL DISTRICT
Other - Org Name:SKAMANIA COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-427-5065
Mailing Address - Street 1:PO BOX 3510
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-3510
Mailing Address - Country:US
Mailing Address - Phone:360-394-7030
Mailing Address - Fax:360-394-7097
Practice Address - Street 1:253 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:STEVENSON
Practice Address - State:WA
Practice Address - Zip Code:98648-6649
Practice Address - Country:US
Practice Address - Phone:509-427-5065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA30X013416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA191639800OtherOWCP-FECA AND ENERGY
OR185074Medicaid
WAP00215101OtherRAILROAD MEDICARE
WA1020839Medicaid
WA0029165OtherL&I AND CRIME VICTIMS
WA0029165OtherL&I AND CRIME VICTIMS