Organization
SWINOMISH INDIAN TRIBAL COMMUNITY
Active
Other names
Swinomish Wellness Program
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MARTIN (BILLER)
(360) 588-2735
Entity
Organization
Contact information
Practice address
17337 RESERVATION RD, LA CONNER, WA 98257-8802
(360) 466-1024
(360) 466-7634
Mailing address
17337 RESERVATION RD, LA CONNER, WA 98257-8802
(360) 466-1024
(360) 466-7634
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60166467
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP60166467
WASHINGTON STATE
WA
Enumeration date
10/12/2016
Last updated
10/12/2016
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