Healthcare Provider Details

I. General information

NPI: 1356371397
Provider Name (Legal Business Name): MAKAH TRIBE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 FORT STREET
NEAH BAY WA
98357
US

IV. Provider business mailing address

PO BOX 410
NEAH BAY WA
98357-0410
US

V. Phone/Fax

Practice location:
  • Phone: 360-645-2233
  • Fax: 360-645-2305
Mailing address:
  • Phone: 360-645-2233
  • Fax: 360-645-2723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE HITCHINS
Title or Position: COO
Credential:
Phone: 360-645-2233