| Shoalwater Bay Indian Tribe | |
|
2373 Old Tokeland Rd Tokeland WA 98590 | |
| (360) 267-8103 | |
| (360) 267-1437 |
| Full Name | Shoalwater Bay Indian Tribe |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2373 Old Tokeland Rd, Tokeland, Washington |
| Authorized Official Name and Position | Carol Johnson (TRIBAL ADMINISTRATOR) |
| Authorized Official Contact | 3602676766 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shoalwater Bay Indian Tribe Po Box 500 Tokeland WA 98590-0500 Ph: (360) 267-0119 | Shoalwater Bay Indian Tribe 2373 Old Tokeland Rd Tokeland WA 98590 Ph: (360) 267-8103 |
| NPI Number | 1003028952 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003028952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |