Healthcare Provider Details

I. General information

NPI: 1356492953
Provider Name (Legal Business Name): JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

834 SHERIDAN ST
PORT TOWNSEND WA
98368-2443
US

IV. Provider business mailing address

834 SHERIDAN ST
PORT TOWNSEND WA
98368-2443
US

V. Phone/Fax

Practice location:
  • Phone: 360-385-2200
  • Fax: 360-379-4381
Mailing address:
  • Phone: 360-385-2200
  • Fax: 360-379-4381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number282NC0060X
License Number StateWA

VIII. Authorized Official

Name: MIKE GLENN
Title or Position: CEO
Credential:
Phone: 360-385-2200