| Port Gamble S'klallam Mental Health | |
|
32014 Little Boston Rd Ne Kingston WA 98346-9734 | |
| (360) 297-9601 | |
| (360) 297-9614 |
| Full Name | Port Gamble S'klallam Mental Health |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 32014 Little Boston Rd Ne, Kingston, Washington |
| Authorized Official Name and Position | Kerstin Margareta Powell (HEALTH CENTER BUSINESS OFFICE MANAG) |
| Authorized Official Contact | 3602979601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Gamble S'klallam Mental Health 32014 Little Boston Rd Ne Kingston WA 98346-9734 Ph: (360) 297-9601 | Port Gamble S'klallam Mental Health 32014 Little Boston Rd Ne Kingston WA 98346-9734 Ph: (360) 297-9601 |
| NPI Number | 1154480051 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154480051 | NPI | - | NPPES |
| 1980929 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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Port Gamble S'klallam Social Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 32014 Little Boston Rd Ne, Kingston, WA 98346 Phone: 360-297-9601 Fax: 360-297-9614 |