Provider Demographics
NPI:1366578064
Name:WENATCHEE VALLEY HOSPITAL
Entity type:Organization
Organization Name:WENATCHEE VALLEY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-663-8711
Mailing Address - Street 1:PO BOX 56
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98807-0056
Mailing Address - Country:US
Mailing Address - Phone:509-663-8711
Mailing Address - Fax:
Practice Address - Street 1:820 N CHELAN AVE
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2028
Practice Address - Country:US
Practice Address - Phone:509-663-8711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WENATCHEE VALLEY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-26
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA048006606282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0152319OtherX5 L&I WVMC HOSP
WA0152319OtherX5 L&I WVMC HOSP
WACI2391Medicare PIN
WA0152319OtherX5 L&I WVMC HOSP
WA300449Medicaid
WACI2395Medicare PIN
WACC8279Medicare PIN
CN8837Medicare PIN
WACU0059Medicare PIN
WA500148Medicare Oscar/Certification
WACI2391Medicare PIN