Provider Demographics
NPI:1447332408
Name:COUNTY OF WHITMAN
Entity type:Organization
Organization Name:COUNTY OF WHITMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-397-6280
Mailing Address - Street 1:310 N MAIN ST
Mailing Address - Street 2:
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 1:310 N MAIN ST
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:WA
Practice Address - Zip Code:99111-1848
Practice Address - Country:US
Practice Address - Phone:509-397-6280
Practice Address - Fax:509-397-6239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA381001351251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5901467Medicaid
WA5901145Medicaid
WA7401433Medicaid
WA5901152Medicaid
WA7071137Medicaid
WA5901145Medicaid