NPIMap

Organization Active NPI

Washington State Department of Corrections Olympic Corrections Center

  • Prison Health Clinic/Center
  • Forks, WA
National Provider Identifier
1194016576
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prison Health Clinic/CenterTaxonomy code 261QP2400X
Legal business name
WASHINGTON STATE DEPARTMENT OF CORRECTIONS OLYMPIC CORRECTIONS CENTER
Practice address
11235 Hoh Mainline
Forks, WA 98331
Phone
(360) 374-7000
Fax
(360) 374-8238
NPI assigned
Apr 20, 2011
Organization subpart
Yes
Parent organization
DEPARTMENT OF CORRECTIONSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Authorized official

Name
Maryann Curl, M.D.
Title
Chief Medical Officer
Phone
(509) 318-3498

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prison Health Clinic/Center 261QP2400X Primary

Addresses

Primary practice location

11235 Hoh Mainline
Forks, WA 98331

Mailing address

PO Box 41100, Mail Stop 41100
Olympia, WA 98504-1100
Phone (360) 725-8213

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
50D0965029Olympic Corrections Center11235 Hoh Mainline, Forks, WA 98331Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Washington State Department of Corrections- Airway Heights Corrections14 organizations share this tax ID, including this one
Part of
Washington State Department of Corrections- Airway Heights Corrections

Other organizations with this tax ID 13

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

View all 13

Locations

11235 Hoh Mainline Rd
Forks, WA 98331
Phone (360) 374-7000

NPI Registry JSON

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1194016576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41100, MAIL STOP 41100",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985041100",
            "telephone_number": "360-725-8213",
            "fax_number": "360-586-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11235 HOH MAINLINE",
            "city": "FORKS",
            "state": "WA",
            "postal_code": "98331",
            "telephone_number": "360-374-7000",
            "fax_number": "360-374-8238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON STATE DEPARTMENT OF CORRECTIONS OLYMPIC CORRECTIONS CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEPARTMENT OF CORRECTIONS",
        "enumeration_date": "2011-04-20",
        "last_updated": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "CURL",
        "authorized_official_first_name": "MARYANN",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "509-318-3498",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forks, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.