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Organization

QUINAULT INDIAN NATION

Active
Other names
ROGER SAUX HEALTH CENTER-MH
Organization subpart
No

Provider details

NPI number
Authorized official
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
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
FEDERAL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1980788
WA
Enumeration date
08/13/2007
Last updated
08/13/2007
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