| |
561 N Tribal Center Rd Skokomish Nation WA 98584-7416 | |
(360) 426-5755 | |
(360) 402-0082 |
Full Name | |
---|---|
Speciality | Family Medicine - Adolescent Medicine |
Location | 561 N Tribal Center Rd, Skokomish Nation, Washington |
Authorized Official Name and Position | Frances L Longshore (BUSINESS OFFICE MANAGER) |
Authorized Official Contact | 3604265755 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
561 N Tribal Center Road Skokomish Nation WA 98584-9748 Ph: (360) 426-5755 | 561 N Tribal Center Rd Skokomish Nation WA 98584-7416 Ph: (360) 426-5755 |
NPI Number | 1396056461 |
---|---|
Provider Enumeration Date | 06/23/2010 |
Last Update Date | 06/23/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396056461 | NPI | - | NPPES |
1042775 | Medicaid | WA |