Healthcare Provider Details

I. General information

NPI: 1083202907
Provider Name (Legal Business Name): GRAYS HARBOR COUNTY PUBLIC HOSPITAL DISTRICT NO 1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2021
Last Update Date: 05/23/2023
Certification Date: 05/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

579 E MAIN ST BLDG 2
ELMA WA
98541
US

IV. Provider business mailing address

GRAYS HARBOR PUBLIC HOSPITAL DISTRICT NO 1 600 E MAIN STREET
ELMA WA
98541
US

V. Phone/Fax

Practice location:
  • Phone: 360-346-2222
  • Fax: 360-346-2192
Mailing address:
  • Phone: 360-346-2222
  • Fax: 360-346-2192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LYNN FIFIELD
Title or Position: MEDICAL STAFF SERVICES DIRECTOR
Credential:
Phone: 360-346-2222