Provider Demographics
NPI:1861269342
Name:COMMUNITY HEALTH OUTREACH
Entity type:Organization
Organization Name:COMMUNITY HEALTH OUTREACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BROOK
Authorized Official - Middle Name:
Authorized Official - Last Name:EASTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-481-7477
Mailing Address - Street 1:2747 PACIFIC AVE SE STE B19
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-2094
Mailing Address - Country:US
Mailing Address - Phone:360-481-7477
Mailing Address - Fax:
Practice Address - Street 1:2747 PACIFIC AVE SE STE B19
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-2094
Practice Address - Country:US
Practice Address - Phone:360-481-7477
Practice Address - Fax:360-350-0697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty