Healthcare Provider Details

I. General information

NPI: 1154378859
Provider Name (Legal Business Name): GRAYS HARBOR COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 ANDERSON DR
ABERDEEN WA
98520-1006
US

IV. Provider business mailing address

1006 N H ST
ABERDEEN WA
98520-2535
US

V. Phone/Fax

Practice location:
  • Phone: 360-537-6116
  • Fax: 360-537-6100
Mailing address:
  • Phone: 360-537-6116
  • Fax: 360-537-6100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number282N00000X
License Number StateWA

VIII. Authorized Official

Name: TIM HOWDEN
Title or Position: CFO
Credential:
Phone: 360-537-6116