NPIMap

Organization Active NPI

Jamestown S'Klallam Tribe

Doing business as Jamestown Healing Clinic

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Sequim, WA
National Provider Identifier
1104901941
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
JAMESTOWN S'KLALLAM TRIBE
Doing business as
Jamestown Healing Clinic
Practice address
526 S 9TH Ave
Sequim, WA 98382-3626
Phone
(360) 681-7755
Fax
(360) 681-5999
NPI assigned
Oct 26, 2006
Last updated
Apr 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
W. Ron Allen
Title
Tribal Chairman/Executive Director
Phone
(360) 683-1109

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Methadone Clinic 261QM2800X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

526 S 9TH Ave
Sequim, WA 98382-3626

Mailing address

526 S 9TH Ave
Sequim, WA 98382-3626
Phone (360) 681-7755

Other names 1

  • Jamestown Healing Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments
Opioid treatment program
Medicare-enrolled since Oct 15, 2022

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050507000057 WA Part B Supplier - Clinic/Group Practice 2365349495 Receives reassigned benefits from 45 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sequim, WA
O20230315002073 WA Part B Supplier - Opioid Treatment Program (Otp) 2365349495 Practice locations: Sequim, WA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Jamestown Fam HLTH Clinic6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Jamestown Family Health ClinicSequim, WA, CCN 501872 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 17, 2010
Jamestown Healing ClinicSequim, WA, CCN 501021 Federally qualified health center 5% Or Greater Direct Ownership Interest May 17, 2010

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776211200000",
    "number": "1104901941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 S 9TH AVE",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823626",
            "telephone_number": "360-681-7755",
            "fax_number": "360-681-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 S 9TH AVE",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823626",
            "telephone_number": "360-681-7755",
            "fax_number": "360-681-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMESTOWN S'KLALLAM TRIBE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "W.",
        "authorized_official_middle_name": "RON",
        "authorized_official_title_or_position": "TRIBAL CHAIRMAN/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "360-683-1109"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jamestown Healing Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sequim, WA

Sources for this page

Verify at the official NPI Registry.