Port Gamble S'klallam Health Center - Medicare Primary Care in Kingston, WA

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Port Gamble S'klallam Health Center is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Kingston, Washington. The current practice location for Port Gamble S'klallam Health Center is 32014 Little Boston Rd Ne, Kingston, Washington. For appointments, you can reach them via phone at (360) 297-9601. The mailing address for Port Gamble S'klallam Health Center is 32014 Little Boston Rd Ne, Kingston, Washington and phone number is (360) 297-9601.

Port Gamble S'klallam Health Center is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1760428650. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (360) 297-9601.

Contact Information

Port Gamble S'klallam Health Center
32014 Little Boston Rd Ne
Kingston
WA 98346-9734
(360) 297-9601
(360) 297-9614

Map and Direction


Primary Care Clinic Profile

Full NamePort Gamble S'klallam Health Center
SpecialityClinic/Center
Location32014 Little Boston Rd Ne, Kingston, Washington
Authorized Official Name and PositionDallas I Deguire (ADMINISTRATIVE DIRECTOR)
Authorized Official Contact3602979601
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Port Gamble S'klallam Health Center
32014 Little Boston Rd Ne
Kingston
WA 98346-9734

Ph: (360) 297-9601		Port Gamble S'klallam Health Center
32014 Little Boston Rd Ne
Kingston
WA 98346-9734

Ph: (360) 297-9601

NPI Details:

NPI Number1760428650
Provider Enumeration Date06/21/2006
Last Update Date01/07/2011

Medicare PECOS Information:

Medicare PECOS PAC ID6204737927
Medicare Enrollment IDO20040115001158

Medical Identifiers

Medical identifiers for Port Gamble S'klallam Health Center such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1760428650NPI-NPPES
1980929MedicaidWA
1992825MedicaidWA
5031810MedicaidWA
7094964MedicaidWA
7094972MedicaidWA
PO1021OtherWAREGENCE RIDER#
0101820OtherWAL&I CLINIC ID#
5031794MedicaidWA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Port Gamble S'klallam Health Center acts as a billing entity for following providers:
Provider NameThayne Bosh
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1174609879
PECOS PAC ID: 0547232423
Enrollment ID: I20040811000281
Provider NameEric Roth
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1427060623
PECOS PAC ID: 4587606561
Enrollment ID: I20050531001037
Provider NameScott W Lindquist
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1780611871
PECOS PAC ID: 0749294684
Enrollment ID: I20060728000146
Provider NameKatayoun N Paydar
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1447401211
PECOS PAC ID: 6709945298
Enrollment ID: I20081113000122
Provider NameJohn R Carlson
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1811949654
PECOS PAC ID: 9739076597
Enrollment ID: I20090427000518
Provider NameLuke B Mcdaniel
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1376633891
PECOS PAC ID: 0941228365
Enrollment ID: I20100422000285
Provider NameKara Stadshaug
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1306278106
PECOS PAC ID: 8022252865
Enrollment ID: I20130918000467
Provider NameAnita P Lemieux
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1972656866
PECOS PAC ID: 1557597499
Enrollment ID: I20131122001470
Provider NameHayley Siegenthaler
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1851793426
PECOS PAC ID: 6002131976
Enrollment ID: I20150217001921
Provider NameMegan Morris
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1922483742
PECOS PAC ID: 2466762091
Enrollment ID: I20151110001978
Provider NameJarel Bakke
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1578006375
PECOS PAC ID: 7618258930
Enrollment ID: I20161228002262
Provider NameShannon White
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1316499411
PECOS PAC ID: 4082995311
Enrollment ID: I20161229000235
Provider NameJacquelyn Gfeller
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1982150678
PECOS PAC ID: 2062793391
Enrollment ID: I20161229000320
Provider NameJennifer Rose Briant
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1932656287
PECOS PAC ID: 6800142134
Enrollment ID: I20180628002918
Provider NameEmily Everett
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1356822613
PECOS PAC ID: 4284987850
Enrollment ID: I20181029001282
Provider NameMichael Kunish
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1568921104
PECOS PAC ID: 3779813829
Enrollment ID: I20191002003502
Provider NameMalina Lorring
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1831609734
PECOS PAC ID: 5890054431
Enrollment ID: I20200128001204
Provider NameJohn Mckeever
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1033729967
PECOS PAC ID: 9739596529
Enrollment ID: I20210323000650
Provider NameSandra Louise Walker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710473590
PECOS PAC ID: 3375946304
Enrollment ID: I20210916002047
Provider NameVibeke Newell
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1366229296
PECOS PAC ID: 1052778719
Enrollment ID: I20230612001642
Provider NameMari C Sullivan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1750449344
PECOS PAC ID: 2668826314
Enrollment ID: I20230928002004
Provider NameJocelyn Valencia
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598545527
PECOS PAC ID: 1557712080
Enrollment ID: I20240109004858
Provider NameMary S Sumner
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1538553300
PECOS PAC ID: 5395196612
Enrollment ID: I20240110003948
Provider NameElizabeth Kelton
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1972610806
PECOS PAC ID: 4587015813
Enrollment ID: I20240110004323
Provider NameDenise Bower
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1558532705
PECOS PAC ID: 8224480314
Enrollment ID: I20240112004075

Reviews and Comments


Clinic/Center in Kingston, WA

Port Gamble S'klallam Tribe
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 32014 Little Boston Rd Ne, Kingston, WA 98346
Phone: 360-297-9614    Fax: 360-297-9614
Kingston Liberty Bay Internal Medicine
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 25995 Barber Cut Off Rd Ne, Kingston, WA 98346
Phone: 360-297-6900    Fax: 360-297-2034
Peninsula Community Health Services
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 25989 Barber Cut Off Rd Ne, Kingston, WA 98346
Phone: 360-377-3776    
Vintage Direct Primary Care
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 25985 Barbr Cutff Rd Ne Ste B1, Kingston, WA 98346
Phone: 360-860-3020    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.