| Grays Harbor County Public Hospital District No. 1 | |
|
105 W Simpson Ave Mccleary WA 98557-9657 | |
| (360) 346-2222 | |
| Not Available |
| Full Name | Grays Harbor County Public Hospital District No. 1 |
|---|---|
| Speciality | Clinic/Center |
| Location | 105 W Simpson Ave, Mccleary, Washington |
| Authorized Official Name and Position | Renee K. Jensen (CEO) |
| Authorized Official Contact | 3603462222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grays Harbor County Public Hospital District No. 1 600 E. Main Street Elma WA 98541 Ph: (360) 346-2222 | Grays Harbor County Public Hospital District No. 1 105 W Simpson Ave Mccleary WA 98557-9657 Ph: (360) 346-2222 |
| NPI Number | 1255401683 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 04/18/2016 |
| Medicare PECOS PAC ID | 9032017256 |
|---|---|
| Medicare Enrollment ID | O20100802000472 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255401683 | NPI | - | NPPES |
| 7105406 | Medicaid | WA | |
| 106276 | Other | WA | L&I |
| 135 | Other | WA | REGENCE PRO |
| 106275 | Other | WA | CRIME VICTIM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | HAC.FS.00000186 (Washington) | Primary |
Black Hills Family Practice Clinic Ps Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 332 S Birch St, Mccleary, WA 98557 Phone: 360-495-3475 |