Organization
GRAYS HARBOR COUNTY PUBLIC HOSPITAL DISTRICT NO. 1
Active
Parent organization
GRAYS HARBOR COUNTY PUBLIC HOSPITAL DISTRICT NO. 1
Other names
Summit Pacific Wellness Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRAYS HARBOR COUNTY PUBLIC HOSPITAL DISTRICT NO. 1
Authorized official
MRS. RENEE K JENSEN (CEO)
(360) 495-3244
Entity
Organization
Contact information
Practice address
610 E MAIN STREET, ELMA, WA 98541-9551
(360) 346-2222
(360) 346-2163
Mailing address
600 E MAIN ST, ELMA, WA 98541-9560
(360) 346-2222
(360) 346-2163
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
HAC.FS.00000186
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7103815
—
WA
Enumeration date
02/28/2007
Last updated
01/18/2019
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