Healthcare Provider Details

I. General information

NPI: 1346210366
Provider Name (Legal Business Name): JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W SIMS WAY STE 300
PORT TOWNSEND WA
98368-2234
US

IV. Provider business mailing address

2500 W SIMS WAY STE 300
PORT TOWNSEND WA
98368-2234
US

V. Phone/Fax

Practice location:
  • Phone: 360-385-0610
  • Fax: 360-379-8259
Mailing address:
  • Phone: 360-385-0610
  • Fax: 360-379-8259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberIS-349
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberIS-349
License Number StateWA

VIII. Authorized Official

Name: DAVID HUNSLEY
Title or Position: DIRECTOR
Credential: RN
Phone: 360-385-0610