SKOKOMISH INDIAN NATION NPI 1528264561

NPI Information

NPI: 1528264561
Provider Name: SKOKOMISH INDIAN NATION
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

CLIA Number: 50D0703174

Address:
N 561 TRIBAL CENTER RD
SHELTON, WA
ZIP 98584
Phone: (360) 426-7788
Get Directions

SKOKOMISH INDIAN NATION is an addiction (substance use disorder) counselor in Shelton, WA. SKOKOMISH INDIAN NATION NPI is 1528264561. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

N 561 TRIBAL CENTER RD
SHELTON, WA
ZIP 98584
Phone: (360) 426-7788
Fax: (360) 462-0082

The provider's authorized official is Malynn Foster .
The authorized official title is Office Manager and has the following contact phone number (360) 426-7788.

The CLIA number assigned to this NPI record is 50D0703174 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/26/2007 and was last updated on 8/22/2020.

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	101YA0400X	Counselor	Addiction (Substance Use Disorder)	CP00000655	WASHINGTON	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	CP00002317	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	1991512	MEDICAID	WASHINGTON

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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