Healthcare Provider Details

I. General information

NPI: 1740211028
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: 07/05/2006
Last Update Date: 08/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E. MAIN STREET
ELMA WA
98541
US

IV. Provider business mailing address

600 E. MAIN STREET
ELMA WA
98541
US

V. Phone/Fax

Practice location:
  • Phone: 360-495-3244
  • Fax: 360-495-4274
Mailing address:
  • Phone: 360-495-3244
  • Fax: 360-495-4274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSHUA MARTIN
Title or Position: CEO
Credential:
Phone: 360-346-2222