# GRAYS HARBOR COUNTY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grays Harbor County Jail Medical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285447938
- **Authorized official:** VICKIE RAINES (GRAYS HARBOR COUNTY COMMISSIONER)
- **Authorized official phone:** (360) 249-3711

## Contact information

- **Practice address:** 100 W. BROADWAY AVENUE, SUITE 3, MONTESANO, WA 98563
- **Practice address phone:** (360) 249-3711
- **Practice address fax:** (360) 249-3722
- **Mailing address:** 100 W. BROADWAY AVENUE, SUITE 3, MONTESANO, WA 98563
- **Mailing address phone:** (360) 249-3711
- **Mailing address fax:** (360) 249-3722

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QP2400X | Prison Health Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 01/28/2025
- **Last updated:** 01/28/2025