Jefferson County Public Hospital District No 2
Organization Active NPI Medical Physician Assistant · Port Townsend, WA
NPI 1194032201 · NPPES record last updated Dec 9, 2010
Key facts
- NPI
- 1194032201
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- HAC.FS.00000085 (WA)
- Legal business name
- JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2
- Practice address
- 1274 7TH St Ste a
Port Townsend, WA 98368-2404 - Phone
- (360) 379-0477
- NPI assigned
- Sep 10, 2010
- Organization subpart
- Yes
- Parent organization (as reported)
- JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2
Authorized official
- Name
- Ms. Kathy Lee Porter, CHAM
- Title
- Registration Coordinator
- Phone
- (360) 385-2200
Other NPIs on the same Medicare enrollment 9
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031111000542 | WA | Part B Supplier - Clinic/Group Practice | 4789593708 |
Receives reassigned benefits from 231 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Quilcene, WA; Port Townsend, WA; Port Ludlow, WA; Bellingham, WA |
National Provider Directory
- Part of
- Jefferson General Hosp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant |
363AM0700X | HAC.FS.00000085 | WA | Yes |
| Family Nurse Practitioner |
363LF0000X | HAC.FS.00000085 | WA |
Addresses
Primary practice location
1274 7TH St Ste a
Port Townsend, WA 98368-2404
Mailing address
834 Sheridan St
Port Townsend, WA 98368-2443
Phone (360) 385-2200
Other names
- Jefferson Healthcare Walk in Clinic
Other providers in Port Townsend, WA
- Jefferson County Public Health
- Jefferson County Public Hospital Dist No 2
- Jefferson County Public Hospital District No 2
- Jefferson County Public Hospital District No 2
- Jefferson County Public Hospital District No 2
- Jefferson County Public Hospital District No 2
- Jefferson County Public Hospital District No 2
- Jefferson County Public Hospital District No 2
- Jefferson County Public Hospital District No 2
- Jefferson County Public Hospital District No 2
All providers in Port Townsend, WA · Medical Physician Assistant in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.