Squaxin Island Medicaid Encounter
NPI #1114135779 in Shelton, Washington
Provider Information
- NPI Number
- 1114135779
- Entity Type
- Organization
- Organization Name
- Squaxin Island Medicaid Encounter
- Primary Specialty
- Clinic/Center
- Enumeration Date
- May 18, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 90 SE KLAH CHE MIN DR
- City
- Shelton
- State
- Washington
- ZIP Code
- 98584-9216
- Phone
- (360) 427-9006
Authorized Official
- Name
- WHITNEY JONES
- Title
- DIRECTOR
- Phone
- (360) 427-9006
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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