Organization
SHOALWATER BAY INDIAN TRIBE
Active
Other names
Shoalwater Bay Tribal Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL JOHNSON (TRIBAL ADMINISTRATOR)
(360) 267-6766
Entity
Organization
Contact information
Practice address
2373 OLD TOKELAND RD, TOKELAND, WA 98590
(360) 267-8103
(360) 267-1437
Mailing address
PO BOX 500, TOKELAND, WA 98590-0500
(360) 267-0119
(360) 267-0417
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/04/2007
Last updated
08/22/2020
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