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Organization
JAMESTOWN S'KLALLAM TRIBE
Active
Organization
JAMESTOWN S'KLALLAM TRIBE
Active
Other names
Jamestown Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
W. RON ALLEN (TRIBAL CHAIRMAN/EXECUTIVE DIRECTOR)
(360) 683-1109
Entity
Organization
Contact information
Practice address
1033 OLD BLYN HWY, SEQUIM, WA 98382-7670
(360) 683-1109
(360) 683-3401
Mailing address
1033 OLD BLYN HWY, SEQUIM, WA 98382-7670
(360) 683-1109
(360) 683-3401
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
NULL
261QP0904X
Federal Public Health Clinic/Center
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7123433
—
WA
Enumeration date
11/01/2006
Last updated
12/29/2021
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