Provider Demographics
NPI:1700811635
Name:CLARK COUNTY CURRENT EXPENSE
Entity Type:Organization
Organization Name:CLARK COUNTY CURRENT EXPENSE
Other - Org Name:CLARK COUNTY PUBLIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGEMENT ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSSAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:564-397-8102
Mailing Address - Street 1:PO BOX 5000
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98666-5000
Mailing Address - Country:US
Mailing Address - Phone:360-397-8000
Mailing Address - Fax:360-397-8110
Practice Address - Street 1:1601 E FOURTH PLAIN BLVD
Practice Address - Street 2:BLDG 17 3RD FLOOR SUITE A338
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3713
Practice Address - Country:US
Practice Address - Phone:360-397-8000
Practice Address - Fax:360-397-8110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1017721Medicaid
WA1019189Medicaid
WA1010976Medicaid
WA1000050Medicaid
WA1022061Medicaid
WA1010976Medicaid