Mattawa Community Medical Clinic – Federally Qualified Health Center (FQHC), NPI 1609410075

Mattawa Community Medical Clinic is a healthcare provider. based in Mattawa, Washington. specializing in Federally Qualified Health Center (FQHC). The NPI Number for Mattawa Community Medical Clinic is 1609410075

Main info

Organization
Name
Mattawa Community Medical Clinic
NPI
1609410075
Phone
(095) 932-4499
Address
PO BOX 1581
Authorized Official
DANA S FOX CEO
Enumeration Date
29 October 2019
Last Update Date
4 June 2025

Contacts

Main Contact
MATTAWA
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness90
Years active:6State licenses:0Updated within 12 months

Provider Addresses for Mattawa Community Medical Clinic

  • PO BOX 1581

    MATTAWA, WA 993490960

    Phone: (095) 932-4499

    Fax: (509) 932-5363

    Type: Mailing

  • 101 WILLIAM AVE

    MATTAWA, WA 993490104

    Phone: (509) 932-4499

    Fax: (509) 932-5363

    Type: Location

  • 210 GOVERNMENT RD

    MATTAWA, WA 993495116

    Phone: (509) 932-4499

    Fax: (509) 932-5363

    Type: Mailing

  • 101 S WILLIAM AVE

    MATTAWA, WA 993490104

    Phone: (509) 932-4499

    Fax: (509) 932-5363

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-06-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20240611004556OFederally Qualified Health Center (Fqhc)WATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 99349)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Mattawa Community Medical Clinic?
Mattawa Community Medical Clinic — NPI 1609410075 — is the standard way to identify this listing.
Can I rely on Mattawa Community Medical Clinic being an active provider?
As of the registry snapshot, Mattawa Community Medical Clinic is marked active.
What is Mattawa Community Medical Clinic's specialty?
The listing groups Mattawa Community Medical Clinic with Federally Qualified Health Center (FQHC). Clinical services aligned with this taxonomy classification.
What area does Mattawa Community Medical Clinic serve?
Mattawa Community Medical Clinic's listing highlights Mattawa, Washington; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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