National Provider Identifier Database

TRI STATE MEMORIAL HOSPITAL
Hospice Care, Community Based


Contact Information

TRI-STATE MEMORIAL HOSPITAL
1100 HIGHLAND AVENUE
CLARKSTON, WA99403
Phone: 509-758-2568
Fax: 509-758-3413
Website:
Specialty Taxonomy Code
* Hospice Care, Community Based 251G00000X

* Indicates primary specialty

NPI Profile & details for TRI-STATE MEMORIAL HOSPITAL

NPI Number 1831100254
Legal business name
LBN
TRI-STATE MEMORIAL HOSPITAL
Authorized official ALEX TOWN - (CFO)
Entity Organization
Organization subpart No
Enumeration date 08/10/2006
Last updated 05/08/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • WA License #: IS457
  • WA Medicaid: 3990470

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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