NPIMap

Organization Active NPI

Suquamish Tribal

Doing business as Suquamish Medical Clinic

  • Family Medicine Physician
  • Suquamish, WA
National Provider Identifier
1114674942
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUQUAMISH TRIBAL
Doing business as
Suquamish Medical Clinic
Practice address
6968 NE Enetai LN
Suquamish, WA 98392-9766
Phone
(360) 394-1350
Fax
(360) 598-2783
NPI assigned
Mar 2, 2022
Last updated
Sep 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Authorized official

Name
Rebecca A Jones
Title
Health Compliance Officer
Phone
(360) 394-1423

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
General Practice Physician 208D00000X NU

Addresses

Primary practice location

6968 NE Enetai LN
Suquamish, WA 98392-9766

Mailing address

PO Box 1228
Suquamish, WA 98392-1228
Phone (360) 394-1423

Other names 1

  • Suquamish Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240216001062 TX Part B Supplier - Clinic/Group Practice 3173975893 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Suquamish, WA

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2198791Suquamish Tribe Healing House Medical Clinic6968 NE Enetai LN, Suquamish, WA 98392Provider-performed microscopyApr 4, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 34

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.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789948800000",
    "number": "1114674942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1228",
            "city": "SUQUAMISH",
            "state": "WA",
            "postal_code": "983921228",
            "telephone_number": "360-394-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6968 NE ENETAI LN",
            "city": "SUQUAMISH",
            "state": "WA",
            "postal_code": "983929766",
            "telephone_number": "360-394-1350",
            "fax_number": "360-598-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUQUAMISH TRIBAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "HEALTH COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "360-394-1423"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Suquamish Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Suquamish, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.