Provider Demographics
NPI:1902983174
Name:SELAH MEDICAL CENTER INC.
Entity type:Organization
Organization Name:SELAH MEDICAL CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:509-697-8008
Mailing Address - Street 1:9 E 1ST AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SELAH
Mailing Address - State:WA
Mailing Address - Zip Code:98942-1400
Mailing Address - Country:US
Mailing Address - Phone:509-697-8008
Mailing Address - Fax:509-697-9872
Practice Address - Street 1:9 E 1ST AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:SELAH
Practice Address - State:WA
Practice Address - Zip Code:98942-1400
Practice Address - Country:US
Practice Address - Phone:509-697-8008
Practice Address - Fax:509-697-9872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001024261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty