Organization
GRAYS HARBOR COUNTY PUBLIC HOSPITAL DISTRICT NO 1
Active
Other names
Summit Pacific Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA MARTIN (CEO)
(360) 346-2222
Entity
Organization
Contact information
Practice address
600 E. MAIN STREET, ELMA, WA 98541
(360) 495-3244
(360) 495-4274
Mailing address
600 E. MAIN STREET, ELMA, WA 98541
(360) 495-3244
(360) 495-4274
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135
PREMERA
WA
01
—
18090
L&I ER DOC NUMBER
WA
01
—
18091
L&I ER FACILITY NUMBER
WA
05
—
3147709
—
WA
05
—
7257108
—
WA
01
—
8903273
CRIME VICTIMS
WA
01
—
8918276
CRIME VICTIM PRO FEE
WA
01
—
GR6577
REGENCE BLUE SHIELD
WA
01
—
QMXPR0048030
MOLINA H/O
WA
Enumeration date
07/05/2006
Last updated
08/22/2017
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