MEDICARE: VITAL HEALTHCARE LLC

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
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1801599121
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 1120
Second Line	:
City	:	MCCLEARY
State	:	WA
Zip	:	98557-1120
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2584 R W JOHNSON BLVD SW STE 102
Second Line	:
City	:	TUMWATER
State	:	WA
Zip	:	98512-6103
Country	:	US
Telephone Number	:	360-455-8288
Fax Number	:	888-464-1120

Authorized Official
Title or Position	:	OWNER
Name	:	THOMAS A GRIFFITH
Credential	:	ND
Telephone Number	:	360-455-8281

Provider Enumeration Date	:	03/24/2023
Last Update Date	:	03/24/2023

Similar Medicare Providers

1922447572 — MS. NELL ELIZABETH NICHOLS BCBA
Practice Location Address:

2584 R W JOHNSON BLVD SW STE 100
TUMWATER, WA
98512-6103

Practice Phone: 360-878-6434
Practice Fax: 844-452-1758

1598359226 — BRITTANY NICOLE HARRIS
Practice Location Address:

2584 R W JOHNSON BLVD SW STE 100
TUMWATER, WA
98512-6103

Practice Phone: 360-878-6434
Practice Fax: 844-452-1758

1174361034 — KENNEDY KLEIN
Practice Location Address:

2584 R W JOHNSON BLVD SW UNIT 100
TUMWATER, WA
98512-6103

Practice Phone: 306-489-6485
Practice Fax:

1689494692 — KYLA BRIANNE BOWMAN
Practice Location Address:

2584 R W JOHNSON BLVD SW
TUMWATER, WA
98512-6103

Practice Phone: 360-878-6434
Practice Fax:

1164220109 — SAMANTHA FOUNTAINE
Practice Location Address:

2584 R W JOHNSON BLVD SW STE 100
TUMWATER, WA
98512-6103

Practice Phone: 360-878-6434
Practice Fax:

1255208203 — ELLIE ROSE COHEN
Practice Location Address:

2584 R W JOHNSON BLVD SW STE 100
TUMWATER, WA
98512-6103

Practice Phone: 360-878-6434
Practice Fax: 844-452-1758

Directions to “VITAL HEALTHCARE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.