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NPI Code Detail

MEDICARE: STILLAGUAMISH TRIBE OF INDIANS

MEDICARE: STILLAGUAMISH TRIBE OF INDIANS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013110956
Entity Type Code : Organization
Provider Name (Legal Business Name) : STILLAGUAMISH TRIBE OF INDIANS
Provider Business Mailing Address
First Line : 902 E MAPLE ST
Second Line :
City : ARLINGTON
State : WA
Zip : 98223-1634
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 902 E MAPLE ST
Second Line :
City : ARLINGTON
State : WA
Zip : 98223-1634
Country : US
Telephone Number : 360-435-9338
Fax Number :
Authorized Official
Title or Position : DIRECTOR, SOCIAL AND HEALTH SERVICE
Name : MR. THOMAS ASHLEY
Credential :
Telephone Number : 360-653-1104
Provider Enumeration Date : 06/07/2007
Last Update Date : 08/22/2020

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1922201862 — STILLAGUAMISH TRIBE OF INDIANS
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Directions to “STILLAGUAMISH TRIBE OF INDIANS ” Practice Location

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