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  5. TRI-STATE MEMORIAL HOSPITAL

TRI-STATE MEMORIAL HOSPITAL

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Company Details

Legal Name: TRI-STATE MEMORIAL HOSPITAL
Jurisdiction: WASHINGTON
Entity Type: WA NONPROFIT CORPORATION
Category: DOMESTIC ENTITY
Other Names: TRI-STATE BEHAVIORAL HEALTH
TRI-STATE MEMORIAL HOSPITAL
Status: Active
Formation/ Registration Date: November 6th 1947
Expiration date: 30 Nov 2025
UBI Number: 022 001 206
ZIP code: 99403
City: Clarkston
County: ASOTIN
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 1221 HIGHLAND AVE, CLARKSTON, WA, 99403-2829, UNITED STATES
Principal Office Mailing Address: Google Maps Logo PO BOX 189, CLARKSTON, WA, 99403-0189, UNITED STATES
Supporting healthcare providers fighting with COVID-19: $7,461,442

Contact Details

E-Mail: AP@TSMH.ORG
Phone Number: +1 509-758-5511

Nature of Business

SCIENTIFIC - NON-PROFIT HOSPITAL

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Registered Agent Information

Name Role Address
LUCY DUKES Registered Agent 843 7TH ST, CLARKSTON, WA, 99403-2021, UNITED STATES

Key Officers & Management

Name Role
WAYNE DAY Governing Person
STEVE CLAASSEN Governing Person

Links between entities

Type:
Headquarter of
Company Number:
551779
State:
IDAHO
IDAHO profile:
TRI-STATE MEMORIAL HOSPITAL (ID)
Type:
Headquarter of
Company Number:
3581769
State:
IDAHO
IDAHO profile:
TRI-STATE MEMORIAL HOSPITAL (ID)

Unique Entity ID

Unique Entity ID:
MLYNU97YA981
CAGE Code:
6VQJ6
UEI Expiration Date:
2026-06-23

Business Information

URL:
https://www.tsh.org/
Activation Date:
2025-06-25
Initial Registration Date:
2013-04-02

Commercial and government entity program

CAGE number:
6VQJ6
Status:
Obsolete
Type:
Non-Manufacturer
CAGE Update Date:
2025-06-25
SAM Expiration:
2026-06-23
CAGE Link:
View company profile on CAGE website

Contact Information

POC:
KYM CLIFT
Corporate URL:
https://www.tsh.org/

National Provider Identifier

NPI Number:
1932405693
Link:
View on NPI website

Authorized Person:

Name:
ALEX TOWN
Role:
CFO
Phone:
5097584667

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
207RN0300X - Nephrology Physician
Is Primary:
No
Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Phone:
+1 509-758-5511
Fax:
5097519406

Tax Exempt

Employer Identification Number (EIN):
91-0545036
In Care Of Name:
% SHANDI OCHOA
Ruling Date:
1952-04
National Taxonomy Of Exempt Entities:
Health Care: Hospitals and Related Primary Medical Care Facilities
Deductibility:
Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns

Return Type:
990T
Tax Period:
202212
Link:
Download 990T
Return Type:
990
Tax Period:
202212
Link:
Download 990
Return Type:
990T
Tax Period:
202112
Link:
Download 990T

Court Cases

Filing Date:
2018-08-17
Status:
Terminated
Nature Of Judgment:
no monetary award
Jury Demand:
Neither plaintiff nor defendant demands jury
Nature Of Suit:
Americans with Disabilities Act - Employment
Parties:
SEMINARA - Plaintiff
TRI-STATE MEMORIAL HOSPITAL - Defendant
Filing Date:
2014-07-22
Status:
Terminated
Nature Of Judgment:
monetary award only
Jury Demand:
Both plaintiff and defendant demand jury
Nature Of Suit:
Civil Rights Employment
Parties:
GLEASON, INCORPORATED - Plaintiff
TRI-STATE MEMORIAL HOSPITAL - Defendant

Facilities

FRS ID:
110015441217
Facility Address:
1221 HIGHLAND AVE, CLARKSTON, ASOTIN, WA, 99403
Link:
View a detailed facility report on Enforcement and Compliance History (ECHO)

Facility NAICS Codes

System:
RCRAINFO
Identifier:
WAH000059360
NAICS Code:
622110
System:
EIS
Identifier:
16149211
NAICS Code:
488119
System:
EIS
Identifier:
12026211
NAICS Code:
488119

Facility SIC Codes

System:
NPDES
Identifier:
WAR310926
SIC Code:
1794

Labor Condition Applications

Case Number:
I-200-23025-726806
Program:
H-1B
Job Title:
Family Medicine Physician
SOC (ONET/OES) code:
29-1215.00
SOC (ONET/OES) occupation title:
Family Medicine Physicians
Begin Date:
2023-07-01
End Date:
2026-06-30

Employment and Wage Information

Address:
1221 Highland Avenue, Clarkston, ASOTIN, WA, 99403
Wage Rate Paid to Nonimmigrant Workers:
$236,935
Per:
Year
Prevailing Wage Rate:
$208,000
Case Number:
I-200-20141-590298
Program:
H-1B
Job Title:
Family Medicine Physician
SOC (ONET/OES) code:
29-1062.00
SOC (ONET/OES) occupation title:
Family and General Practitioners
Begin Date:
2020-07-01
End Date:
2023-06-30

Employment and Wage Information

Address:
1119 Highland Avenue, Clarkston, ASOTIN, WA, 99403
Wage Rate Paid to Nonimmigrant Workers:
$236,935
Per:
Year
Prevailing Wage Rate:
$114,566
Case Number:
I-200-20122-536513
Program:
H-1B
Job Title:
Family Medicine Physician
SOC (ONET/OES) code:
29-1062.00
SOC (ONET/OES) occupation title:
Family and General Practitioners
Begin Date:
2020-07-01
End Date:
2023-06-30

Employment and Wage Information

Address:
1991 Highland Avenue, Clarkston, ASOTIN, WA, 99403
Wage Rate Paid to Nonimmigrant Workers:
$236,935
Per:
Year
Prevailing Wage Rate:
$114,566
Case Number:
I-200-19114-860510
Program:
H-1B
Job Title:
NEPHROLOGIST
SOC (ONET/OES) code:
29-1069
SOC (ONET/OES) occupation title:
PHYSICIANS AND SURGEONS, ALL OTHER
Begin Date:
2019-07-01
End Date:
2022-06-30

Employment and Wage Information

Address:
1119 Highland Avenue, Clarkston, Asotin, WASHINGTON, 99403
Wage Rate Paid to Nonimmigrant Workers:
$324,973
Per:
Year
Prevailing Wage Rate:
$208,000
Case Number:
I-200-19108-913302
Program:
H-1B
Job Title:
NEPHROLOGIST
SOC (ONET/OES) code:
29-1069
SOC (ONET/OES) occupation title:
PHYSICIANS AND SURGEONS, ALL OTHER
Begin Date:
2019-07-01
End Date:
2022-06-30

Employment and Wage Information

Address:
1221 Highland Avenue, Clarkston, Asotin, WASHINGTON, 99403
Wage Rate Paid to Nonimmigrant Workers:
$324,793
Per:
Year
Prevailing Wage Rate:
$208,000

Related by address

1221 HIGHLAND AVE, CLARKSTON, WA, 99403-2829, UNITED STATES

TRI-STATE MEMORIAL HOSPITAL AUXILIARY
WA NONPROFIT CORPORATION - Active
VANNVEI, LLC
WA LIMITED LIABILITY COMPANY - Active

PO BOX 189, CLARKSTON, WA, 99403-0189, UNITED STATES

TRI-STATE MEMORIAL HOSPITAL AUXILIARY
WA NONPROFIT CORPORATION - Active
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