SQUAXIN ISLAND CHEMICAL DEPENDENCY ENCOUNTER (NPI# 1912112244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912112244 |
| Entity Type | Organization |
| Organization Name | SQUAXIN ISLAND CHEMICAL DEPENDENCY ENCOUNTER |
| Other Organization Name | SQUAXIN ISLAND TRIBE |
| 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 | 2007-05-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | WHITNEY JONES (DIRECTOR) |
| Authorized Official Telephone | 3604279006 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1990696 | 05 |
| Other Name | Type Code |
|---|---|
| Squaxin Island Tribe | Other Name - Individual/Organization |
| Street Address |
90 SE KLAH CHE MIN DR |
| City | SHELTON |
| State | WA |
| Zip Code | 98584-9216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669532578 | Squaxin Island Tribe | Clinic/Center | 90 Se Klah Che Min Dr, Shelton, WA 98584-9216 | 2006-12-11 |
| 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 |
| 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 | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952437824 | Educational Service District 113 | Clinic/Center | 807 W Pine St, Shelton, WA 98584-2562 | 2007-02-26 |
| 1669944724 | Progressive Institute LLC | Clinic/Center | 2 Trap Falls Rd Ste 120, Shelton, CT 06484-4616 | 2018-12-28 |
| 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 |
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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.