Provider Demographics
NPI:1033139431
Name:KITTITAS COUNTY PUBLIC HOSPITAL DIST 1
Entity type:Organization
Organization Name:KITTITAS COUNTY PUBLIC HOSPITAL DIST 1
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR REVENUE CYCLE
Authorized Official - Prefix:MRS
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-962-7424
Mailing Address - Street 1:P.O. BOX 799
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926
Mailing Address - Country:US
Mailing Address - Phone:509-962-9841
Mailing Address - Fax:509-925-8486
Practice Address - Street 1:603 S. CHESTNUT ST.
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926
Practice Address - Country:US
Practice Address - Phone:509-962-7424
Practice Address - Fax:509-933-8692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAH-140275N00000X
WA273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA835OtherGROUP HEALTH COOPERATIVE
WA0011427OtherST OF WASH LABOR & INDUST
WA356OtherBLUE CROSS OF WASH
WA3342300Medicaid
WA50-Z333Medicare UPIN
WA835OtherGROUP HEALTH COOPERATIVE