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General NPI Number Information
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NPI Number | 1457506081
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Entity Type | Organization
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Legal Business Name | SKOKOMISH TRIBAL COUNCIL
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Dates
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Enumeration Date | 11/24/2008
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Last Update Date | 06/18/2010
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Provider Practice Location Address
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Address Line | 100 N TRIBAL CENTER RD
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City | SKOKOMISH NATION
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State | WA
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Zip | 98584-9748
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Country | US
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Telephone | 360-426-5755
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Fax | 360-877-2032
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Provider Business Mailing Address
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Address Line | 100 N TRIBAL CENTER RD
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City | SKOKOMISH NATION
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State | WA
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Zip | 98584-9748
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Country | US
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Telephone | 360-426-5755
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Fax | 360-877-2032
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | MS. FRANCES LONGSHORE
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Credential |
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Telephone | 360-426-5755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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