JAMESTOWN S'KLALLAM TRIBE NPI 1104901941

NPI Information

NPI: 1104901941
Provider Name: JAMESTOWN S'KLALLAM TRIBE

Doing Business As: JAMESTOWN HEALING CLINIC

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
526 S 9TH AVE
SEQUIM, WA
ZIP 98382
Phone: (360) 681-7755
Get Directions

JAMESTOWN S'KLALLAM TRIBE is a rehabilitation and substance use disorder clinic center in Sequim, WA. JAMESTOWN S'KLALLAM TRIBE NPI is 1104901941. 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 enumeration date for this NPI number is 10/26/2006 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	Primary
1	208D00000X	General Practice		No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	No
3	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	Yes

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
1	1981141	MEDICAID	WASHINGTON

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

NPI Synchronization or Removal

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