| Quinault Indian Nation | |
| 
					1505 Kla-ook-wa Drive Taholah WA 98587  | |
| (360) 276-4405 | |
| (360) 276-4602 | 
| Full Name | Quinault Indian Nation | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 1505 Kla-ook-wa Drive, Taholah, Washington | 
| Authorized Official Name and Position | Mariah Yvonne Ralston (OFFICE MANAGER) | 
| Authorized Official Contact | 3602764405 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Quinault Indian Nation Po Box 219 1505 Kla-ook-wa Dr. Taholah WA 98587 Ph: (360) 276-4405  | Quinault Indian Nation 1505 Kla-ook-wa Drive Taholah WA 98587 Ph: (360) 276-4405  | 
| NPI Number | 1093888547 | 
|---|---|
| Provider Enumeration Date | 11/15/2006 | 
| Last Update Date | 05/27/2008 | 
| Medicare PECOS PAC ID | 0446147086 | 
|---|---|
| Medicare Enrollment ID | O20040301000160 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1093888547 | NPI | - | NPPES | 
| 7082191 | Medicaid | WA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary | 
| Provider Name | Julie M Buck | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1346280484 PECOS PAC ID: 9335134519 Enrollment ID: I20040922000133  | 
| Provider Name | Elizabeth Swift | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1114233731 PECOS PAC ID: 6901090901 Enrollment ID: I20101103001295  | 
| Provider Name | Dale Austin Armstrong | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1871586578 PECOS PAC ID: 0941214548 Enrollment ID: I20230628001300  | 
| Provider Name | Kristen A Hodsdon | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1821007600 PECOS PAC ID: 5294875621 Enrollment ID: I20230630002459  | 
| Provider Name | Julia Elizabeth Mackaronis | 
|---|---|
| Provider Type | Practitioner - Clinical Psychologist | 
| Provider Identifiers | NPI Number: 1497123855 PECOS PAC ID: 0749649465 Enrollment ID: I20230706002331  | 
| Provider Name | Samantha Capoeman | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1184480741 PECOS PAC ID: 1850829482 Enrollment ID: I20250110001059  |