| Chehalis Tsapowum Mental Health | |
|
420 Howanut Rd Oakville WA 98568-9659 | |
| (360) 709-1628 | |
| (360) 273-8957 |
| Full Name | Chehalis Tsapowum Mental Health |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 420 Howanut Rd, Oakville, Washington |
| Authorized Official Name and Position | Gary Goodwin (SYSTEM ADMINISTRATOR) |
| Authorized Official Contact | 3608670709 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chehalis Tsapowum Mental Health 420 Howanut Rd Oakville WA 98568-9659 Ph: (360) 709-1628 | Chehalis Tsapowum Mental Health 420 Howanut Rd Oakville WA 98568-9659 Ph: (360) 709-1628 |
| NPI Number | 1043636442 |
|---|---|
| Provider Enumeration Date | 03/10/2014 |
| Last Update Date | 03/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043636442 | NPI | - | NPPES |
| 1346383379 | Other | WA | CHEHALIS MEDICAL NPI |
| 1008323 | Other | WA | MEDICAID PROVIDER ONE DOMAIN ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 14 0096 00 (Washington) | Primary |
The Chehalis Tribal Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 Howanut Rd, Oakville, WA 98568 Phone: 360-858-1660 Fax: 360-858-7300 |