Organization
QUINAULT INDIAN NATION
Active
Other names
Roger Saux Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAH Y RALSTON (BILLING OFFICE MANAGER)
(360) 276-4405
Entity
Organization
Contact information
Practice address
1505 KLA-OOK-WA DRIVE, TAHOLAH, WA 98587-0219
(360) 276-4405
(360) 276-4474
Mailing address
PO BOX 219, TAHOLAH, WA 98587-0219
(360) 276-4405
(360) 276-4474
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8894265
MEDICARE PTAN
—
Enumeration date
01/25/2012
Last updated
01/25/2012
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