Organization
HOODSPORT FAMILY CLINIC,P.S.
Active
Organization
HOODSPORT FAMILY CLINIC,P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID LEE MOORE (ADMINISTRATOR)
(360) 877-0372
Entity
Organization
Contact information
Practice address
24261 NORTH US HIGHWAY 101, HOODSPORT, WA 98548-0279
(360) 877-0372
(360) 877-0565
Mailing address
PO BOX 279, HOODSPORT, WA 98548-0279
(360) 877-0372
(360) 877-0565
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
S71181
WA
261QR1300X
Rural Health Clinic/Center
Primary
503884
WA
Other
Enumeration date
07/11/2005
Last updated
12/09/2010
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