Healthcare Provider Details

I. General information

NPI: 1427241744
Provider Name (Legal Business Name): SOPHIE TRETTEVICK INDIAN HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WELLNESS WAY
NEAH BAY WA
98357
US

IV. Provider business mailing address

PO BOX 410 100 WELLNESS WAY
NEAH BAY WA
98357
US

V. Phone/Fax

Practice location:
  • Phone: 360-645-2461
  • Fax: 360-645-3343
Mailing address:
  • Phone: 360-645-2461
  • Fax: 360-645-3343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELLE HITCHINS
Title or Position: CHIEF OPERATIONS OFFICER
Credential:
Phone: 360-645-2536