GRAYS HARBOR COUNTY PUBLIC HOSPITAL DISTRICT NO. 1 NPI 1255401683

NPI Information

NPI: 1255401683
Provider Name: GRAYS HARBOR COUNTY PUBLIC HOSPITAL DISTRICT NO. 1

Doing Business As: DBA-MCCLEARY HEALTHCARE CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
105 W SIMPSON AVE
MCCLEARY, WA
ZIP 98557
Phone: (360) 346-2222
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GRAYS HARBOR COUNTY PUBLIC HOSPITAL DISTRICT NO. 1 is a rural health clinic center in Mccleary, WA. GRAYS HARBOR COUNTY PUBLIC HOSPITAL DISTRICT NO. 1 NPI is 1255401683. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Dba-mccleary Healthcare Clinic.

The provider's business location address is:

105 W SIMPSON AVE
MCCLEARY, WA
ZIP 98557-657
Phone: (360) 346-2222

The provider's authorized official is Renee K. Jensen .
The authorized official title is Ceo and has the following contact phone number (360) 346-2222.

The CLIA number assigned to this NPI record is 50D0707184 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/9/2006 and was last updated on 4/18/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine				No
2	261QR1300X	Clinic/Center	Rural Health	HAC.FS.00000186	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	503998	MEDICARE ID-TYPE UNSPECIFIED	WASHINGTON	RURAL HEALTH CLINIC ID
2	106275	OTHER	WASHINGTON	CRIME VICTIM
3	106276	OTHER	WASHINGTON	L&I
4	7105406	MEDICAID	WASHINGTON
5	G000800088	MEDICARE PIN	WASHINGTON
6	135	OTHER	WASHINGTON	REGENCE PRO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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