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General NPI Number Information
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NPI Number | 1114674942
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Entity Type | Organization
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Legal Business Name | SUQUAMISH TRIBAL
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Dates
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Enumeration Date | 03/02/2022
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Last Update Date | 08/21/2026
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Provider Practice Location Address
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Address Line | 6968 NE ENETAI LN
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City | SUQUAMISH
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State | WA
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Zip | 98392-9766
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Country | US
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Telephone | 360-394-1350
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Fax | 360-598-2783
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Provider Business Mailing Address
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Address Line | PO BOX 1228
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City | SUQUAMISH
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State | WA
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Zip | 98392-1228
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Country | US
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Telephone | 360-394-1423
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Fax |
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Authorized Official
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Title or Position | HEALTH COMPLIANCE OFFICER
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Name | REBECCA A JONES
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Credential |
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Telephone | 360-394-1423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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