Organization
PORT GAMBLE S'KLALLAM SOCIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERSTIN MARGARETA POWELL (HEALTH CENTER BUSINESS OFFICE MANAG)
(360) 297-9601
Entity
Organization
Contact information
Practice address
32014 LITTLE BOSTON RD NE, KINGSTON, WA 98346-9734
(360) 297-9601
(360) 297-9614
Mailing address
32014 LITTLE BOSTON RD NE, KINGSTON, WA 98346-9734
(360) 297-9601
(360) 297-9614
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1981125
—
WA
Enumeration date
04/03/2007
Last updated
08/22/2020
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