Organization
SQUAXIN ISLAND CHEMICAL DEPENDENCY ENCOUNTER
Active
Other names
Squaxin Island Tribe
Organization subpart
No
Provider details
NPI number
Authorized official
WHITNEY JONES (DIRECTOR)
(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
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1990696
—
WA
Enumeration date
05/11/2007
Last updated
08/22/2020
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