JEFFERSON UROLOGY CLINIC – NPI #1174917033
Urology

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Health Care Provider Taxonomy Code for Urology

JEFFERSON UROLOGY CLINIC is an urologist located in PORT TOWNSEND, WA. NPPES has assigned the NPI number 1174917033 to JEFFERSON UROLOGY CLINIC on March 27, 2015. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “JEFFERSON UROLOGY CLINIC” is a dba name, the actual legal business name for this organization is JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2. This provider is also associated with 2 additional names listed below. The primary taxonomy selected by this provider is 208800000X from the Health Care Provider Taxonomy code set, which is classified as Urology.

The NPI profile was previously updated about 6 years ago on Oct 29, 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 JEFFERSON UROLOGY CLINIC below.

NPI Profile for
JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2

NPI Number
1174917033
Enumeration Date

(more than 11 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
JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2
Doing Business As (dba): JEFFERSON UROLOGY CLINIC
Other name(s)
All associated names:
Doing Business As (dba)
Jefferson Healthcare Urology Clinic
Doing Business As (dba)
JEFFERSON UROLOGY CLINIC
Primary location
1274 7TH ST STE B
PORT TOWNSEND, WA 98368-2404
Phone: (360) 385-2905 Fax: (360) 385-6796
Mailing address
834 SHERIDAN ST
PORT TOWNSEND, WA 98368-2443
Phone: (360) 385-2200 Fax: (360) 379-2256
Organization Subpart
No
Authorized Official
MIKE GLENN
CEO
Phone: (360) 385-2200
Updated
Certification Date
Oct 29, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

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
208800000X
- Urology (Primary)		 WA HAC.FS.00000085

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.