Organization
QUINAULT INDIAN NATION
Active
Other names
ROGER SAUX HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MARIAH YVONNE RALSTON (BILLING MANAGER)
(360) 276-4405
Entity
Organization
Contact information
Practice address
1505 KLA-OOK-WA DR, TAHOLAH, WA 98587
(360) 276-4405
(360) 276-4474
Mailing address
1505 KLA-OOK-WA DR, TAHOLAH, WA 98587
(360) 276-4405
(360) 276-4474
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
FEDERAL FACILITY
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7082191
—
WA
Enumeration date
08/09/2007
Last updated
08/09/2007
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