Healthcare Provider Details

I. General information

NPI: 1710148606
Provider Name (Legal Business Name): THE CHEHALIS TRIBAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2008
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 HOWANUT RD
OAKVILLE WA
98568
US

IV. Provider business mailing address

PO BOX 570
OAKVILLE WA
98568-0570
US

V. Phone/Fax

Practice location:
  • Phone: 360-858-1660
  • Fax: 360-858-7300
Mailing address:
  • Phone: 360-858-1660
  • Fax: 360-858-7300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. KRIS SALMON
Title or Position: CFO
Credential:
Phone: 360-858-1521