GRANDE RONDE PSYCHIATRIC SERVICES PC NPI 1306183801

NPI Information

NPI: 1306183801
Provider Name: GRANDE RONDE PSYCHIATRIC SERVICES, PC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
435 W BELL ST
STE. B-1
SEQUIM, WA
ZIP 98382
Phone: (360) 477-3298
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GRANDE RONDE PSYCHIATRIC SERVICES, PC is a mental health (including community mental health center) clinic center in Sequim, WA. GRANDE RONDE PSYCHIATRIC SERVICES, PC NPI is 1306183801. The provider is registered as an organization entity type.

The provider's business location address is:

435 W BELL ST
STE. B-1
SEQUIM, WA
ZIP 98382-916
Phone: (360) 477-3298
Fax: (360) 452-9584

The provider's authorized official is Terry Allen Trudel .
The authorized official title is President and has the following contact phone number (360) 477-3298.

The enumeration date for this NPI number is 1/4/2013 and was last updated on 1/4/2013.

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
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	MD60053143	WASHINGTON	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	C64085	MEDICARE UPIN	OREGON
2	0265930	OTHER	WASHINGTON	LABOR AND INDUSTRIES
3	113092	MEDICAID	OREGON

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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