Shoalwater Bay Tribal Clinic | |
2373 Old Tokeland Rd Tokeland WA 98590 | |
(360) 267-0119 | |
(360) 267-0417 |
Full Name | Shoalwater Bay Tribal Clinic |
---|---|
Speciality | Clinic/Center |
Location | 2373 Old Tokeland Rd, Tokeland, Washington |
Authorized Official Name and Position | Michael Rogers (TRIBAL ADMINISTRATOR) |
Authorized Official Contact | 3602676766 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Shoalwater Bay Tribal Clinic Po Box 500 Tokeland WA 98590-0500 Ph: (360) 267-0119 | Shoalwater Bay Tribal Clinic 2373 Old Tokeland Rd Tokeland WA 98590 Ph: (360) 267-0119 |
NPI Number | 1063624740 |
---|---|
Provider Enumeration Date | 05/04/2007 |
Last Update Date | 08/25/2015 |
Medicare PECOS PAC ID | 8820986599 |
---|---|
Medicare Enrollment ID | O20040305000564 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063624740 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Johnny S Bell |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1356362081 PECOS PAC ID: 8022132364 Enrollment ID: I20100824000462 |
Provider Name | Megan Colburn |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922482074 PECOS PAC ID: 6507174661 Enrollment ID: I20151009001140 |
Provider Name | Melody Blum |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083178347 PECOS PAC ID: 3375872708 Enrollment ID: I20190911000853 |
Provider Name | Sarah N Lewis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841863164 PECOS PAC ID: 5193120509 Enrollment ID: I20221005001930 |
Shoalwater Bay Tribal Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2373 Old Tokeland Rd, Tokeland, WA 98590 Phone: 360-267-0119 Fax: 360-267-0417 |