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Organization

PORT GAMBLE S'KLALLAM MENTAL HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KERSTIN MARGARETA POWELL (HEALTH CENTER BUSINESS OFFICE MANAG)
(360) 297-9601
Entity
Organization

Contact information

Practice address
32014 LITTLE BOSTON RD NE, KINGSTON, WA 98346-9734
(360) 297-9601
(360) 297-9614
Mailing address
32014 LITTLE BOSTON RD NE, KINGSTON, WA 98346-9734
(360) 297-9601
(360) 297-9614

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1980929
WA
Enumeration date
12/06/2006
Last updated
08/22/2020
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