| Northwest Indian Treatment Center | |
|
100 Se Whitener Rd Shelton WA 98584-7747 | |
| (360) 470-1474 | |
| Not Available |
| Full Name | Northwest Indian Treatment Center |
|---|---|
| Speciality | Clinic/center |
| Location | 100 Se Whitener Rd, Shelton, Washington |
| Authorized Official Name and Position | June O'brien (DIRECTOR) |
| Authorized Official Contact | 3604701474 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Indian Treatment Center 308 E. Young St. Box 477 Elma WA 98541 Ph: () - | Northwest Indian Treatment Center 100 Se Whitener Rd Shelton WA 98584-7747 Ph: (360) 470-1474 |
| NPI Number | 1215063169 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215063169 | NPI | - | NPPES |
| 1990696 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 23037400 (Washington) | Primary |
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