Organization · Type 2 NPI

Grant County Public Hospital District No 5

Federally Qualified Health Center (FQHC) · Mattawa, WA

NPI number 1609410075 Active

Practice location

101 S William Ave
Mattawa, WA 99349-0104

Call (509) 932-4499 Map

Fax (509) 932-5363

Mailing address

210 Government Rd
Mattawa, WA 99349-5116

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed
Mental Health Clinic/Center (Including Community Mental Health Center)	261QM0801X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

Another provider at this address

Josilyn Brook Baugher, ARNPPsychiatric/Mental Health Nurse Practitioner Mattawa, WA NPI 1285311951

Other federally qualified health center (fqhc) providers in Mattawa

See all in Mattawa →

NPI record

NPI: 1609410075
Entity type: Organization (Type 2)
Issued: Oct 29, 2019
Last updated: Jun 4, 2025
Status: Active
Subpart: Yes of Grant County Public Hospital District No. 5

Other names

<unavail>
Mattawa Community Medical Clinic · doing business as
Mattawa Community Medical Clinic · doing business as

Authorized official

Dana S Fox
CEO
(509) 932-4499

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1609410075

Grant County Public Hospital District No 5's National Provider Identifier is 1609410075, issued on Oct 29, 2019. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Mattawa, WA. The record was last updated on Jun 4, 2025.