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JAMESTOWN S'KLALLAM TRIBE NPI 1023195161


NPI Information

NPI: 1023195161
Provider Name: JAMESTOWN S'KLALLAM TRIBE

Doing Business As: JAMESTOWN HEALING CLINIC

Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 50D2256615

Address:
526 S 9TH AVE
SEQUIM, WA
ZIP 98382
Phone: (360) 681-7755
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JAMESTOWN S'KLALLAM TRIBE is a general practice in Sequim, WA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee JAMESTOWN S'KLALLAM TRIBE NPI is 1023195161. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Jamestown Healing Clinic.

The provider's business location address is:

526 S 9TH AVE
SEQUIM, WA
ZIP 98382-626
Phone: (360) 681-7755
Fax: (360) 681-5999

The provider's authorized official is W. Ron Allen .
The authorized official title is Tribal Chairman/executive Director and has the following contact phone number (360) 683-1109.

The CLIA number assigned to this NPI record is 50D2256615 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/1/2006 and was last updated on 5/3/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
22083P0901XPreventive MedicinePublic Health & General Preventive MedicineNo
3261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)No
4208D00000XGeneral PracticeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11991355MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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