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WILLAPA MEDICAL CLINIC
NPI 1760582522
Clinic/Center - Rural Health in South Bend, WA

Active since September 22, 2006CLIA 50D0637268 · Waiver
826 ALDER ST, SOUTH BEND, WA 98586(360) 875-5579(360) 875-5235 Get Directions Write a Review

NPPES record last updated: October 8, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 8, 2020, Feb 26, 2020 (2 updates tracked since 2020).

About Willapa Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLAPA MEDICAL CLINIC (NPI 1760582522) is a healthcare organization registered as a rural health in South Bend, Washington and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Mary Mcallister, Clinic Manager, as its authorized official.

NPPES Registry Identity

NPI1760582522
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NamePACIFIC COUNTY HOSPITAL DISTRICT 2
Location Address826 ALDER STSouth Bend, WA 98586-4900
Mailing AddressPo Box 269, 826 Alder St.South Bend, WA 98586-0269 · (360) 875-5579 · Fax (360) 875-5235
Phone(360) 875-5579
Fax(360) 875-5235
Organization SubpartNo
Authorized OfficialMary McallisterClinic Manager · (360) 875-5579
Enumeration DateSeptember 22, 2006
Last NPPES UpdateOctober 8, 20202 updates tracked since enumeration
NPPES CertifiedOctober 8, 2020
✔ NPI 1760582522 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedFamily MedicineTaxonomy 207Q00000X
826 ALDER ST, South Bend, WA 98586
Open in Google Maps ↗

Other Names 1

Doing Business AsWillapa Medical Clinic

Other Identifiers 6

Medicaid1035732WA
Medicaid9621491WA
Other0317075WA · Labor & Industries-dr. Buben
OtherGAB11482WA · Rendering Pin Buben
Other0317062WA · Labor & Industries-pfhc
Other0317067WA · Labor & Industries-jared Abrams

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D0637268

Willapa Medical Clinic · South Bend, WA
Active · expires Apr 4, 2028
CLIA Number50D0637268
Laboratory TypePhysician Office
Certificate Effective DateOctober 24, 2005
Certificate Expiration DateApril 4, 2028
Laboratory DirectorSandra Montgomery
Laboratory Phone(360) 875-5579
Laboratory LocationWillapa Medical Clinic826 Alder St, South Bend, WA 98586
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL CHARLES BUBEN
Family Medicine
826 ALDER ST
SOUTH BEND, WA 98586
Pacific County (360) 875-5579
MRS. SHERRY A FRANKS PA-C
Physician Assistant
826 ALDER ST
SOUTH BEND, WA 98586
Pacific County (360) 875-5579
JACK HAMSON M.D.
Internal Medicine
826 ALDER ST
SOUTH BEND, WA 98586
Pacific County (360) 875-5579

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pacific County Hospital District 2's NPI number?

The NPI number for Pacific County Hospital District 2 is 1760582522. It was assigned to this organization in the NPPES registry on September 22, 2006. The provider is doing business as Willapa Medical Clinic.

Where is Pacific County Hospital District 2 located?

Pacific County Hospital District 2 is located at 826 Alder St, South Bend, WA 98586. The listed phone number is (360) 875-5579.

What is Pacific County Hospital District 2's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Pacific County Hospital District 2 hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D0637268) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pacific County Hospital District 2 accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Pacific County Hospital District 2 as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pacific County Hospital District 2 was last updated on October 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.