STAFFORD CREEK CORRECTIONS CENTER (NPI# 1427349802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427349802 |
| Entity Type | Organization |
| Organization Name | STAFFORD CREEK CORRECTIONS CENTER |
| Practice Address |
191 Constantine Way Aberdeen WA 98520-9504 |
| Mailing Address |
Po Box 41107 Olympia WA 98504-1107 |
| Practice Telephone | 3605371800 |
| Practice Fax Number | 3605372075 |
| Mailing Telephone | 3607258298 |
| Mailing Fax Number | 3605861320 |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2011-04-20 |
| Authorized Official Name | LOUIS MCDERMOTT (HEALTHCARE FINANCE MANAGER) |
| Authorized Official Telephone | 3607258301 |
| Is Organization Subpart | Y |
| Parent Organization Name | DEPARTMENT OF CORRECTIONS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2400X |
Clinic/Center Specialization: Prison Health |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | STAFFORD CREEK CORRECTIONS CENTER EMPLOYEES ASSOCIATION RECRUITMENT AND RETENTION COMMITTEE | 191 Constantine Way, Aberdeen, WA 98520 |
| Street Address |
191 CONSTANTINE WAY |
| City | ABERDEEN |
| State | WA |
| Zip Code | 98520-9504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952506420 | Stafford Creek Correction Center | Public Health or Welfare | 191 Constantine Way, Aberdeen, WA 98520-9504 | 2007-06-15 |
| 1467068452 | Teresa Torres | Psychologist | 191 Constantine Way, Aberdeen, WA 98520-9504 | 2020-09-16 |
| 1730430380 | Erin M Lystad | Physician Assistant | 191 Constantine Way, Aberdeen, WA 98520-9504 | 2012-09-23 |
| 1215240049 | Luciano Luis Figueroa | Physician Assistant | 191 Constantine Way, Aberdeen, WA 98520-9504 | 2010-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740755354 | Wchs, Inc. | Clinic/Center | 516 East 1st Street, Aberdeen, WA 98520 | 2018-10-10 |
| 1518454180 | Katie Cutshaw | Counselor | 1700 Cherry Street, Suite C, Aberdeen, WA 98520 | 2018-04-18 |
| 1629587738 | Robert Williams | Counselor | Catholic Community Services, 403 West State Street, Suite 206, Aberdeen, WA 98520 | 2017-09-21 |
| 1174032296 | Amy D Tyler | Peer Specialist | 403 W State Street, Ste 206, Aberdeen, WA 98520 | 2017-09-20 |
| 1073032819 | Amanda Leona Franklin | Counselor | 2700 Simpson Ave, Suite 101, Aberdeen, WA 98520 | 2017-09-13 |
| 1184141152 | Chrystal Lynn Beckley | Counselor | 2700 Simpson Avenue Suite 101, Aberdeen, WA 98520 | 2017-08-29 |
| 1285158923 | Josh Butler | Technician/Technologist | 1718 Sumner Ave, Aberdeen, WA 98520 | 2017-08-02 |
| 1386165553 | Melvin Taylor | Counselor | 311 South I Street, Aberdeen, WA 98520 | 2017-06-28 |
| 1164870267 | Kelly Knittle | Counselor | 4820 She-nah-num Dr. Se, Olympia, WA 98520 | 2016-05-31 |
| 1437570249 | Aberdeen Therapy Works | Occupational Therapist | 100 S. I Street, Suite 205, Aberdeen, WA 98520 | 2013-12-20 |
| Find all providers in zip 98520 | ||||
| Taxonomy Code | 261QP2400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Prison Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902197882 | Airway Heights Correction Center | Clinic/Center | 11919 W. Sprague Avenue, Airway Heights, WA 99001-1899 | 2011-04-26 |
| 1194016576 | Olympic Correction Center | Clinic/Center | 11235 Hoh Mainline Rd, Forks, WA 98331-9492 | 2011-04-20 |
| 1538450911 | Larch Corrections Center | Clinic/Center | 15314 Ne Dole Valley Rd, Yacolt, WA 98675-9521 | 2011-04-20 |
| 1861813834 | Wa State Department of Corrections Headquarters | Clinic/Center | 7345 Linderson Way Sw, Tumwater, WA 98501-6504 | 2013-12-18 |
| 1588955306 | Monroe Correctional Complex | Clinic/Center | 16550 177th Ave Se, Monroe, WA 98272 | 2011-04-27 |
| 1750672572 | Cedar Creek Corrections Center | Clinic/Center | 12200 Bordeaux Road, Littlerock, WA 98556-0037 | 2011-04-27 |
| 1114218591 | Washington Corrections Center for Women | Clinic/Center | 9601 Bujacich Rd Nw, Gig Harbor, WA 98332-8300 | 2011-04-20 |
| 1902197387 | Clallam Bay Corrections Center | Clinic/Center | 1830 Eagle Crest Way, Clallam Bay, WA 98326-9724 | 2011-04-20 |
| 1629369095 | Coyote Ridge Corrections Center | Clinic/Center | 1301 N Ephrata Ave, Connell, WA 99326-9601 | 2011-04-20 |
| 1164713558 | Washington State Penitentiary | Clinic/Center | 1313 N 13th Ave, Walla Walla, WA 99362-8817 | 2011-04-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.