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General NPI Number Information
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NPI Number | 1578163317
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Entity Type | Organization
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Legal Business Name | KLAHOWYA SCHOOL BASE HEALTH CENTER
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Dates
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Enumeration Date | 10/30/2020
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Last Update Date | 10/30/2020
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Provider Practice Location Address
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Address Line | 7607 NW NEWBERRY HILL RD RM CLINIC
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City | SILVERDALE
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State | WA
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Zip | 98383-7313
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Country | US
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Telephone | 360-377-3776
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Fax | 360-373-2096
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Provider Business Mailing Address
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Address Line | 400 WARREN AVE STE 200
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City | BREMERTON
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State | WA
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Zip | 98337-1467
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Country | US
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Telephone | 360-475-6711
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Fax | 360-373-2096
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Authorized Official
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Title or Position | REVENUE CYCLE MANAGER
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Name | ALISA GI8BSON
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Credential |
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Telephone | 360-475-6711
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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 | 261QA0005X
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Taxonomy Name | Ambulatory Family Planning Facility
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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 | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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