SAN JUAN HEALTHCARE PC NPI 1407055742

NPI Information

NPI: 1407055742
Provider Name: SAN JUAN HEALTHCARE PC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
689 AIRPORT CENTER DR SUITE B
FRIDAY HARBOR, WA
ZIP 98250
Phone: (360) 378-1338
Get Directions

SAN JUAN HEALTHCARE PC is a primary care clinic center in Friday Harbor, WA. SAN JUAN HEALTHCARE PC NPI is 1407055742. The provider is registered as an organization entity type.

The provider's business location address is:

689 AIRPORT CENTER DR SUITE B
FRIDAY HARBOR, WA
ZIP 98250
Phone: (360) 378-1338
Fax: (360) 378-8130

The provider's authorized official is John Burk Gossom .
The authorized official title is Owner and has the following contact phone number (360) 378-1338.

The enumeration date for this NPI number is 7/17/2007 and was last updated on 3/4/2011.

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	261QR1300X	Clinic/Center	Rural Health			No
2	261QP2300X	Clinic/Center	Primary Care			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	7990344	OTHER	CONNECTICUT	AETNA
2	361929500	OTHER	WASHINGTON	PARKS NATL L&I
3	PENDING	OTHER	WASHINGTON	DSHS
4	=========	OTHER	WASHINGTON	CIGNA BEECH ST
5	50D0990556	OTHER	WASHINGTON	CLIA
6	9451SA	OTHER	WASHINGTON	REGENCE
7	POO425655DG2646	OTHER	WASHINGTON	RAILROAD MEDICARE
8	=========	OTHER	WASHINGTON	CHPW
9	I46552	MEDICARE UPIN	WASHINGTON
10	PENDING	OTHER	WASHINGTON	MEDICARE
11	612622200	OTHER	WASHINGTON	US NATL PARK SERVICE
12	=========	OTHER	WASHINGTON	FIRST CHOICE
13	7138829	MEDICAID	WASHINGTON
14	J5122	OTHER	WASHINGTON	RAILROAD MEDICARE
15	0152516	OTHER	WASHINGTON	LABOR AND INDUSTRIES
16	602732862	OTHER	WASHINGTON	UBI
17	748121	OTHER	WASHINGTON	GROUP HEALTH COOPERATIVE
18	8937841	OTHER	WASHINGTON	CRIME VICTIMS
19	=========	OTHER	WASHINGTON	PREMERA
20	PENDING	MEDICARE UPIN	WASHINGTON
21	612622200	OTHER	WASHINGTON	US CUSTOMAS & BORDER PROTECTION
22	=========	OTHER	WASHINGTON	UNIFORM
23	7135981	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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