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NPI Code Detail

MEDICARE: MUCKLESHOOT INDIAN TRIBE

MEDICARE: MUCKLESHOOT INDIAN TRIBE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332800000XIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
2261Q00000XClinic/Center

General Provider Information

NPI Number : 1558448175
Entity Type Code : Organization
Provider Name (Legal Business Name) : MUCKLESHOOT INDIAN TRIBE
Provider Business Mailing Address
First Line : 17500 SE 392ND ST
Second Line :
City : AUBURN
State : WA
Zip : 98092-9705
Country : US
Telephone Number : 253-939-6648
Fax Number : 253-887-8737
Provider Business Practice Location Address
First Line : 17500 SE 392ND ST
Second Line :
City : AUBURN
State : WA
Zip : 98092-9705
Country : US
Telephone Number : 253-939-6648
Fax Number : 253-887-8737
Authorized Official
Title or Position : HEALTH MANAGER
Name : MS. KATHLEEN GOODWIN-SNYDER
Credential :
Telephone Number : 253-939-6648
Provider Enumeration Date : 11/01/2006
Last Update Date : 01/11/2017

Similar Medicare Providers

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17500 SE 392ND ST
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1689621534 — DR. JAMES HAMPTON JR. MD
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1104862309 — SANDRA KALVODA RITLAND M.D.
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1922010909 — DR. ROBERT ALAN OSBORNE D.D.S.
Practice Location Address:
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1225112097 — DR. ANN MAYEDA D.D.S.
Practice Location Address:
17500 SE 392ND ST
AUBURN, WA
98092-9705
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Directions to “MUCKLESHOOT INDIAN TRIBE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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