Organization
LOWER ELWHA MATERNAL SUPPORT SERVICES
Active
Parent organization
LOWER ELWHA KLALLAM TRIBE
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOWER ELWHA KLALLAM TRIBE
Authorized official
FLORENCE PATRICIA MCEACHRANE-GROSS MD (MEDICAL & HEALTH DIRECTOR)
(360) 452-6252
Entity
Organization
Contact information
Practice address
243511 W HIGHWAY 101, PORT ANGELES, WA 98363-9472
(360) 452-6252
(360) 452-6274
Mailing address
243511 W HIGHWAY 101, PORT ANGELES, WA 98363-9472
(360) 452-6252
(360) 452-6274
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7402480
—
WA
Enumeration date
04/01/2010
Last updated
04/19/2010
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