PORT GAMBLE S'KLALLAM TRIBE NPI 1518585579

NPI Information

NPI: 1518585579
Provider Name: PORT GAMBLE S'KLALLAM TRIBE
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 50D0722309

Address:
32014 LITTLE BOSTON RD NE
KINGSTON, WA
ZIP 98346
Phone: (360) 297-9614
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PORT GAMBLE S'KLALLAM TRIBE is a federally qualified health center (fqhc) clinic center in Kingston, WA. PORT GAMBLE S'KLALLAM TRIBE NPI is 1518585579. The provider is registered as an organization entity type.

The provider's business location address is:

32014 LITTLE BOSTON RD NE
KINGSTON, WA
ZIP 98346-734
Phone: (360) 297-9614
Fax: (360) 297-9614

The provider's authorized official is Kerstin M Powell .
The authorized official title is Health Services Business Manager and has the following contact phone number (360) 297-9649.

The CLIA number assigned to this NPI record is 50D0722309 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/7/2020 and was last updated on 7/7/2020.

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	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

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

NPI Synchronization or Removal

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