| Quinault Indian Nation | |
|
1505 Kla-ook-wa Dr Taholah WA 98587 | |
| (360) 276-4405 | |
| (360) 276-4474 |
| Full Name | Quinault Indian Nation |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1505 Kla-ook-wa Dr, Taholah, Washington |
| Authorized Official Name and Position | Mariah Yvonne Ralston (BILLING MANAGER) |
| Authorized Official Contact | 3602764405 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Quinault Indian Nation 1505 Kla-ook-wa Dr Taholah WA 98587 Ph: (360) 276-4405 | Quinault Indian Nation 1505 Kla-ook-wa Dr Taholah WA 98587 Ph: (360) 276-4405 |
| NPI Number | 1457542847 |
|---|---|
| Provider Enumeration Date | 08/09/2007 |
| Last Update Date | 08/09/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457542847 | NPI | - | NPPES |
| 7082191 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | FEDERAL FACILITY (* (Not Available)) | Primary |