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Organization
SWINOMISH INDIAN TRIBAL COMMUNITY
Active
Organization
SWINOMISH INDIAN TRIBAL COMMUNITY
Active
Other names
Swinomish Wellness Program
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MARTIN (BILLER)
(360) 588-2735
Entity
Organization
Contact information
Practice address
17337 RESERVATION RD, LA CONNER, WA 98257-8802
(360) 466-1024
(360) 466-7634
Mailing address
17337 RESERVATION RD, LA CONNER, WA 98257-8802
(360) 466-1024
(360) 466-7634
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60166467
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP60166467
WASHINGTON STATE
WA
Enumeration date
10/12/2016
Last updated
10/12/2016
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