QUINAULT CHEMICAL DEPEDENCY (NPI# 1518180744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518180744 |
| Entity Type | Organization |
| Organization Name | QUINAULT CHEMICAL DEPEDENCY |
| Practice Address |
1505 Kla-ook-wa Dr Taholah WA 98587-0219 |
| Mailing Address |
Po Box 219 1505 Kla-ook-wa Dr Taholah WA 98587 |
| Practice Telephone | 3602764405 |
| Practice Fax Number | 3602769991 |
| Mailing Telephone | 3602764405 |
| Mailing Fax Number | 3602769991 |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2012-03-01 |
| Authorized Official Name | DAVID A HAGEN (PROGRAM MANAGER) |
| Authorized Official Telephone | 3602764405 |
| Authorized Official Credential | CDP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1992817 | 05 |
| Street Address |
1505 KLA-OOK-WA DR |
| City | TAHOLAH |
| State | WA |
| Zip Code | 98587-0219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225657844 | Pavel Mitin | Pharmacist | 1505 Kla-ook-wa Dr, Taholah, WA 98587 | 2020-04-14 |
| 1932678224 | Tricia Dee Bumgarner | Massage Therapist | 1505 Kla-ook-wa Dr, Taholah, WA 98587 | 2018-11-16 |
| 1851563860 | Mary Louise Hart | Nurse Practitioner | 1505 Kla-ook-wa Dr, Taholah, WA 98587 | 2008-03-31 |
| 1477737781 | Holly Anne Mullins | Massage Therapist | 1505 Kla-ook-wa Dr, Taholah, WA 98587 | 2007-12-21 |
| 1750573911 | Quinault Indian Nation | Clinic/Center | 1505 Kla-ook-wa Dr, Taholah, WA 98587 | 2007-08-13 |
| 1457542847 | Quinault Indian Nation | Clinic/Center | 1505 Kla-ook-wa Dr, Taholah, WA 98587 | 2007-08-09 |
| 1255533196 | Patricia Ohlsen | Counselor | 1505 Kla-ook-wa Dr, Taholah, WA 98587 | 2007-06-04 |
| 1265642219 | Gregory G Kozlowski | Dentist | 1505 Kla-ook-wa Dr, Taholah, WA 98587 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194985499 | Lisa Hall | Emergency Medical Technician, Paramedic | 1505 Kal-ook-wah Drive, Taholah, WA 98587 | 2008-06-11 |
| 1427171628 | Roger Saux Health Center | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1505 Klaookwa Drive, Taholah, WA 98587 | 2007-04-10 |
| 1609997766 | Alyson Gale Roby | Family Medicine | 1505 Kla-ook-wah Dr, Taholah, WA 98587 | 2007-04-03 |
| 1588799571 | Hope Errin Edwards | Counselor | 1505 Kla-ook-wa Way, Taholah, WA 98587 | 2007-02-22 |
| 1093888547 | Quinault Indian Nation | Clinic/Center | 1505 Kla-ook-wa Drive, Taholah, WA 98587 | 2006-11-15 |
| 1538240155 | Taholah School District | Local Education Agency (LEA) | 600 Chitwhin Drive, Taholah, WA 98587 | 2006-10-18 |
| 1548502016 | Alex Eugene Fabini | Counselor | 1505 Kla-ook-wa Drive, Taholah, WA 98587 | 2013-03-22 |
| 1962771782 | Ernie V Sanchez | Counselor | 1505 Kla-ook-wa Drive, Taholah, WA 98587 | 2011-12-22 |
| 1861700080 | Gary D Faber | Counselor | 1505 Kla-ook-wa Drive, Taholah, WA 98587 | 2010-09-22 |
| 1912238080 | Dawn Rae Bankson | Nurse Practitioner | 1505 Kla-ook-wa Drive, Taholah, WA 98587 | 2010-01-28 |
| Find all providers in zip 98587 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275145682 | Sea Mar Community Health Centers | Clinic/Center | 4100 194th St Sw Ste 120, Lynnwood, WA 98036-4613 | 2020-08-18 |
| 1386278372 | Social Treatment Opportunity Programs II, Inc | Clinic/Center | 600 S 1st Ave, Othello, WA 99344-1703 | 2020-02-27 |
| 1326672692 | Excelsior Integrated Care Center LLC | Clinic/Center | 3910 W. Indian Trail Rd, Spokane, WA 99208-4739 | 2020-02-26 |
| 1659919561 | Baart Behavioral Health Services, Inc. | Clinic/Center | 716 S Chase St, Port Angeles, WA 98362-6122 | 2019-12-11 |
| 1346888260 | Baart Behavioral Health Services, Inc. | Clinic/Center | 1520 Ne Riddell Rd Ste 110, Bremerton, WA 98310-3005 | 2019-12-11 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1780174441 | American Behavioral Health Systems, Inc. | Clinic/Center | 715 E Sprague Ave Ste 107, Spokane, WA 99202-2142 | 2018-05-17 |
| 1598255267 | American Behavioral Healt Systems, Inc. | Clinic/Center | 7208 267th St Nw Ste A-100, Stanwood, WA 98292-6289 | 2018-05-17 |
| 1437648136 | American Behavioral Health Systems, Inc. | Clinic/Center | 8625 Evergreen Way Ste 100, Everett, WA 98208-2620 | 2018-05-08 |
| 1487143350 | Steve Parker | Clinic/Center | 1206 State Ave Ste H, Marysville, WA 98270-3645 | 2018-05-07 |
| 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.