National Provider Identifier Database

SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION
Critical Access


Contact Information

SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION
1016 TACOMA AVE
SUNNYSIDE, WA98944
Phone: 509-837-1500
Fax: 509-837-1533
Website:
Specialty Taxonomy Code
* Critical Access 282NC0060X
Medicare Defined Swing Bed Unit 275N00000X
Multi-Specialty 261QM1300X

* Indicates primary specialty

NPI Profile & details for SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION

NPI Number 1225033814
Legal business name
LBN
SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION
Authorized official MATHEW MATHIESEN - (CFO)
Entity Organization
Organization subpart No
Enumeration date 06/20/2005
Last updated 10/10/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • WA License #: 600 581 630
  • WA Medicaid: 3300076
  • WA Other: 10250 LABOR & INDUSTRIES
  • WA Other: 147 PREMERA BLUE CROSS
  • WA Other: SU9354 REGENCE BLUE SHIELD

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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