NPIMap

Organization Active NPI

Quinault Indian Nation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Aberdeen, WA
National Provider Identifier
1124860283
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
QUINAULT INDIAN NATION
Practice address
511 W Heron St
Aberdeen, WA 98520-6022
Phone
(564) 544-1950
Fax
(564) 544-1928
NPI assigned
Jun 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Jason G Halstead, COO
Title
Chief Operations Officer
Phone
(564) 544-1930

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X

Addresses

Primary practice location

511 W Heron St
Aberdeen, WA 98520-6022

Mailing address

511 W Heron St
Aberdeen, WA 98520-6022
Phone (564) 544-1950

Other names 1

  • Quinault Wellness Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240412001895 TX Part B Supplier - Clinic/Group Practice 2860836988 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aberdeen, WA

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Quinault Indian Nation4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1124860283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 W HERON ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985206022",
            "telephone_number": "564-544-1950",
            "fax_number": "564-544-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 W HERON ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985206022",
            "telephone_number": "564-544-1950",
            "fax_number": "564-544-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUINAULT INDIAN NATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-10",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "HALSTEAD",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "564-544-1930",
        "authorized_official_credential": "COO"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quinault Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aberdeen, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.