institution
Port Gamble S'klallam Tribe
Federally Qualified Health Center (FQHC) in Kingston, Washington
NPI 1760428650

Port Gamble S'klallam Tribe is a Federally Qualified Health Center (FQHC) based in Kingston, WA and is specialized in Federally Qualified Health Center (FQHC). Port Gamble S'klallam Tribe practices in Kingston, WA. The NPI Number for Port Gamble S'klallam Tribe is 1760428650 and holds a License No. (Washington).

The current practice location address for Port Gamble S'klallam Tribe is 32014 Little Boston Rd Ne, Kingston, WA and can be reached out via phone at 360-297-9601 and via fax at 360-297-9614.

Location: 32014 Little Boston Rd Ne, Kingston, WA, 98346-9734
institution
Provider Profile Details
NPI Number
1760428650
Provider Name
Port Gamble S'klallam Tribe
Credential
Provider Entity Type
Organization
Address
32014 Little Boston Rd Ne, Kingston, WA, 98346-9734
Phone Number
360-297-9601
Fax Number
360-297-9614
Provider Enumeration Date
06/21/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1980929 05 WA
1992825 05 WA
5031810 05 WA
7094964 05 WA
7094972 05 WA
PO1021 01 WA REGENCE RIDER#
0101820 01 WA L&I CLINIC ID#
5031794 05 WA
institution
Provider Business Practice Location Address Details
Address
32014 Little Boston Rd Ne
City
State
Zip
98346-9734
Phone Number
360-297-9601
Fax Number
360-297-9614
person
Provider Business Mailing Address Details
Address
32014 Little Boston Rd Ne
City
State
Zip
98346-9734
Phone Number
360-297-9601
Fax Number
360-297-9614
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
License No.
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Definition
Definition to come...
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