Healthcare Provider Details

I. General information

NPI: 1811878085
Provider Name (Legal Business Name): SUQUAMISH TRIBAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2025
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9750 LEVIN RD NW
SILVERDALE WA
98383-8399
US

IV. Provider business mailing address

PO BOX 1228
SUQUAMISH WA
98392-1228
US

V. Phone/Fax

Practice location:
  • Phone: 360-698-3437
  • Fax: 360-698-6600
Mailing address:
  • Phone: 360-394-5200
  • Fax: 360-598-1724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: REBECCA ANN JONES
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 360-394-1423