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Squaxin Island Medicaid Encounter
Clinic/Center in Shelton, Washington
NPI 1114135779

Squaxin Island Medicaid Encounter is a Clinic/Center based in Shelton, WA. Squaxin Island Medicaid Encounter practices in Shelton, WA. The NPI Number for Squaxin Island Medicaid Encounter is 1114135779 and holds a License No. (Washington).

The current practice location address for Squaxin Island Medicaid Encounter is 90 Se Klah Che Min Dr, Shelton, WA and can be reached out via phone at 360-427-9006.

Location: 90 Se Klah Che Min Dr, Shelton, WA, 98584-9216
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1114135779
Provider Name
Squaxin Island Medicaid Encounter
Credential
Provider Entity Type
Organization
Address
90 Se Klah Che Min Dr, Shelton, WA, 98584-9216
Phone Number
360-427-9006
Fax Number
Provider Enumeration Date
05/18/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7003767 05 WA
institution
Provider Business Practice Location Address Details
Address
90 Se Klah Che Min Dr
City
Shelton
State
Washington
Zip
98584-9216
Phone Number
360-427-9006
Fax Number
person
Provider Business Mailing Address Details
Address
90 Se Klah Che Min Dr
City
Shelton
State
Washington
Zip
98584-9216
Phone Number
360-427-9006
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
(Washington)
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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