Organization
SQUAXIN ISLAND TRIBE
Active
Other names
Squaxin Island Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD J. FOX PHD (DIRECTOR HHS)
(360) 427-9006
Entity
Organization
Contact information
Practice address
90 SE KLAH CHE MIN DR, SHELTON, WA 98584-9216
(360) 427-9006
(360) 427-1951
Mailing address
90 SE KLAH CHE MIN DR, SHELTON, WA 98584-9216
(360) 427-9006
(360) 427-1951
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1980994
—
WA
05
—
7003767
—
WA
05
—
7047772
—
WA
Enumeration date
12/11/2006
Last updated
06/17/2008
Update your record
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