Provider Demographics
NPI:1518378884
Name:KVH
Entity type:Organization
Organization Name:KVH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:509-773-4020
Mailing Address - Street 1:310 S ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:GOLDENDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98620-9201
Mailing Address - Country:US
Mailing Address - Phone:509-773-4020
Mailing Address - Fax:
Practice Address - Street 1:310 S ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:GOLDENDALE
Practice Address - State:WA
Practice Address - Zip Code:98620-9201
Practice Address - Country:US
Practice Address - Phone:509-773-4020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00065003282NR1301X
WAAP30001359282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural