Healthcare Provider Details

I. General information

NPI: 1437259165
Provider Name (Legal Business Name): CLALLAM COUNTY PUBLIC HOSPITAL DISTRICT 2
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2006
Last Update Date: 01/31/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E FRONT ST
PORT ANGELES WA
98362-3636
US

IV. Provider business mailing address

939 CAROLINE ST
PORT ANGELES WA
98362-3909
US

V. Phone/Fax

Practice location:
  • Phone: 360-417-7315
  • Fax: 360-452-3531
Mailing address:
  • Phone: 360-417-7000
  • Fax: 360-417-7602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberIS-393
License Number StateWA

VIII. Authorized Official

Name: MR. DARRYL J. WOLFE
Title or Position: CEO
Credential:
Phone: 360-417-7705