SQUAXIN ISLAND TRIBE (NPI# 1669532578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669532578 |
| Entity Type | Organization |
| Organization Name | SQUAXIN ISLAND TRIBE |
| Other Organization Name | SQUAXIN ISLAND HEALTH CLINIC |
| Practice Address |
90 Se Klah Che Min Dr Shelton WA 98584-9216 |
| Practice Telephone | 3604279006 |
| Practice Fax Number | 3604271951 |
| Mailing Telephone | 3604279006 |
| Mailing Fax Number | 3604271951 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2008-06-17 |
| Authorized Official Name | EDWARD J. FOX (DIRECTOR HHS) |
| Authorized Official Telephone | 3604279006 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7003767 | 05 | |
| WA | 1980994 | 05 | |
| WA | 7047772 | 05 |
| Other Name | Type Code |
|---|---|
| Squaxin Island Health Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548378318 | Squaxin Island Tribe | Pharmacist | 90 Se Klah Che Min Drive, Shelton, WA 98584 | 2006-08-29 |
| 1023226685 | Squaxin Island Tribe | Clinic/Center | 90 Se Klah Che Min Drive, Shelton, WA 98584 | 2007-05-18 |
| Street Address |
90 SE KLAH CHE MIN DR |
| City | SHELTON |
| State | WA |
| Zip Code | 98584-9216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386263820 | Deneice Gurrad | Pharmacist | 90 Se Klah Che Min Dr, Shelton, WA 98584-9216 | 2020-04-14 |
| 1316329980 | Jonathan Corbin Wilton | Family Medicine | 90 Se Klah Che Min Dr, Shelton, WA 98584-9216 | 2015-06-19 |
| 1619241882 | Douglas Reitsch | Pharmacist | 90 Se Klah Che Min Dr, Shelton, WA 98584-9216 | 2012-03-05 |
| 1063647923 | Pamela Lynn Peters | Registered Nurse | 90 Se Klah Che Min Dr, Shelton, WA 98584-9216 | 2009-05-21 |
| 1114184579 | Susan Rowson | Counselor | 90 Se Klah Che Min Dr, Shelton, WA 98584-9216 | 2008-05-21 |
| 1205007762 | Brenda Dorsey | Counselor | 90 Se Klah Che Min Dr, Shelton, WA 98584-9216 | 2008-03-12 |
| 1114135779 | Squaxin Island Medicaid Encounter | Clinic/Center | 90 Se Klah Che Min Dr, Shelton, WA 98584-9216 | 2007-05-18 |
| 1598973158 | Squaxin Island Medical Encounter | Clinic/Center | 90 Se Klah Che Min Dr, Shelton, WA 98584-9216 | 2007-05-18 |
| 1255546578 | Squaxin Island Dental Clinic Ffs | Clinic/Center | 90 Se Klah Che Min Dr, Shelton, WA 98584-9216 | 2007-05-11 |
| 1003021338 | Squaxin Island Dental Clinic Encounter | Clinic/Center | 90 Se Klah Che Min Dr, Shelton, WA 98584-9216 | 2007-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023627478 | Ashley Maria Elena Armstrong | Counselor | 307 W Cota St Shelton, Shelton, WA 98584 | 2020-07-30 |
| 1962011015 | Perry Philemon Little IIi | Dentist | 503 N 4th St, Shelton, WA 98584 | 2020-07-24 |
| 1588215271 | Rebecca Lynn Adams | Counselor | 601 West Franklin St, Shelton, WA 98584 | 2019-09-24 |
| 1366939670 | Robbie Chandler | Social Worker | 807 West Pine, Shelton, WA 98584 | 2018-04-23 |
| 1831603075 | Fir Lane Health-shelton,llc | Skilled Nursing Facility | 2430 North 13th St, Shelton, WA 98584 | 2017-11-27 |
| 1306361738 | Christine Lee Woods | Counselor | 58150 E. 66th Road, Miami, OK 98584 | 2017-08-07 |
| 1174063051 | Claudette V. Selkridge | Counselor | 1620 N. Olympic Hwy, Shelton, WA 98584 | 2017-02-27 |
| 1003278755 | Edward Charles Herman | Social Worker | 50 Se Bluff Loop Rd., Shelton, WA 98584 | 2016-03-22 |
| 1023497310 | Darren Cuevas | Family Medicine | 939 Mountain View Dr Ste 100, Shelton, WA 98584 | 2015-05-20 |
| 1639572977 | Thomas Vincent Phung Duffy | Dentist | 717 W. Railroad Ave., Shelton, WA 98584 | 2014-10-01 |
| Find all providers in zip 98584 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| 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). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669508537 | Northwest Indian Treatment Center | Clinic/Center | 100 Se Whitener Rd, Shelton, WA 98584-7747 | 2007-02-26 |
| 1306275409 | Public Hospital District No 1 of Mason County | Clinic/Center | 221 Professional Way, Shelton, WA 98584-4404 | 2013-11-08 |
| 1821427527 | Public Hospital District No 1 of Mason County | Clinic/Center | 237 Professional Way, Shelton, WA 98584-4404 | 2013-11-04 |
| 1548699408 | Public Hospital District No 1 of Mason County | Clinic/Center | 24261 North Us Highway 101, Shelton, WA 98548-0279 | 2013-11-01 |
| 1679803126 | Public Hospital District No 1 of Mason County | Clinic/Center | 2300 Kati Ct, Suite A, Shelton, WA 98584-1900 | 2010-01-06 |
| 1316174774 | Public Hospital District No 1 of Mason County Wa | Clinic/Center | 2300 Kati Ct, Suite A, Shelton, WA 98584-1900 | 2009-06-12 |
| 1114135779 | Squaxin Island Medicaid Encounter | Clinic/Center | 90 Se Klah Che Min Dr, Shelton, WA 98584-9216 | 2007-05-18 |
| 1215063169 | Northwest Indian Treatment Center | Clinic/Center | 100 Se Whitener Rd, Shelton, WA 98584-7747 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457153 | Scandia Wellness | Clinic/Center | 121 Naylor Rd, Mossyrock, WA 98564-9507 | 2020-11-07 |
| 1699376152 | Seattle Vision Therapy and Rehabilitation Center, Pllc | Clinic/Center | 13344 1st Ave Ne Ste 101, Seattle, WA 98125-3059 | 2020-11-02 |
| 1942811211 | Little Fin Therapies, LLC | Clinic/Center | 5942 31st Ave Sw, Seattle, WA 98126-2910 | 2020-08-11 |
| 1578187829 | Therapy Northwest Pllc | Clinic/Center | 310 3rd Ave Ne Ste 124, Issaquah, WA 98027-3350 | 2020-06-02 |
| 1922621721 | Riaz Pllc | Clinic/Center | 8378 W Grandridge Blvd Ste 110, Kennewick, WA 99336-5401 | 2020-05-27 |
| 1295356848 | Community Health Care | Clinic/Center | 16329 Se 318th St, Auburn, WA 98092-9284 | 2020-05-05 |
| 1720617533 | Nova Mind-body LLC | Clinic/Center | 116 13th Ave E Apt 1e, Seattle, WA 98102-6142 | 2020-04-03 |
| 1609403054 | Lavender Luxe Massage | Clinic/Center | 100 3rd St Ste 100, Davenport, WA 99122-5008 | 2020-03-25 |
| 1417582255 | Personalized Health, LLC | Clinic/Center | 7136 Mlk Jr Way S Ste 204, Seattle, WA 98118-3526 | 2020-03-11 |
| 1912530932 | Lummi Indian Business Council | Clinic/Center | 2924 Haxton Way, Bellingham, WA 98226-9265 | 2020-02-18 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SQUAXIN ISLAND TRIBE.
| 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.