Organization
JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2
Active
Organization
JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2
Active
Other names
Jefferson Healthcare Port Ludlow Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE GLENN (CEO)
(360) 385-2200
Entity
Organization
Contact information
Practice address
89 BREAKER LN, PORT LUDLOW, WA 98365-9766
(360) 385-2200
(360) 379-2282
Mailing address
PO BOX 104546, PASADENA, CA 91189-4546
(360) 385-2200
(360) 379-2282
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/06/2011
Last updated
12/31/2025
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