SHOALWATER BAY TRIBAL CLINIC – NPI #1003028952
Clinic/Center

SHOALWATER BAY TRIBAL CLINIC is an AHC clinic located in TOKELAND, WA. NPPES has assigned the NPI number 1003028952 to SHOALWATER BAY TRIBAL CLINIC on May 04, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SHOALWATER BAY TRIBAL CLINIC” is a dba name, the actual legal business name for this organization is SHOALWATER BAY INDIAN TRIBE. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SHOALWATER BAY TRIBAL CLINIC below.

NPI Profile for
SHOALWATER BAY INDIAN TRIBE

NPI Number
1003028952
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SHOALWATER BAY INDIAN TRIBE
Doing Business As (dba): SHOALWATER BAY TRIBAL CLINIC
Primary location
2373 OLD TOKELAND RD
TOKELAND, WA 98590
Phone: (360) 267-8103 Fax: (360) 267-1437
Mailing address
PO BOX 500
TOKELAND, WA 98590-0500
Phone: (360) 267-0119 Fax: (360) 267-0417
Organization Subpart
No
Authorized Official
CAROL JOHNSON
TRIBAL ADMINISTRATOR
Phone: (360) 267-6766
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.