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General NPI Number Information
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NPI Number | 1932957453
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Entity Type | Organization
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Legal Business Name | JAMESTOWN S'KLALLAM TRIBE
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Dates
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Enumeration Date | 05/09/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 675 N 5TH AVE STE 3A
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City | SEQUIM
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State | WA
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Zip | 98382-3066
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Country | US
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Telephone | 360-582-4876
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Fax |
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Provider Business Mailing Address
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Address Line | 808 N 5TH AVE
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City | SEQUIM
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State | WA
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Zip | 98382-3045
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Country | US
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Telephone | 360-582-4876
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | CINDY L. LOWE
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Credential |
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Telephone | 360-582-4876
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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 | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health 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 | 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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