Swinomish Indian Tribal Community

Organization Active NPI Addiction (Substance Use Disorder) Counselor · La Conner, WA

NPI 1235689381 · NPPES record last updated Oct 12, 2016

Key facts

NPI
1235689381
Entity type
Organization (NPI type 2)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CO60166467 (WA)
Legal business name
SWINOMISH INDIAN TRIBAL COMMUNITY
Practice address
17337 Reservation Rd
La Conner, WA 98257-8802
Phone
(360) 466-1024
Fax
(360) 466-7634
NPI assigned
Oct 12, 2016
Organization subpart
No

Authorized official

Name
Jennifer Martin
Title
Biller
Phone
(360) 588-2735

Corporate family (same tax ID) 9

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

National Provider Directory

Tax ID family
Swishomish Indian Healt (10 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101YA0400X CO60166467 WA Yes

Addresses

Primary practice location

17337 Reservation Rd
La Conner, WA 98257-8802

Mailing address

17337 Reservation Rd
La Conner, WA 98257-8802
Phone (360) 466-1024

Other identifiers

IdentifierTypeStateIssuer
CP60166467OtherWAWASHINGTON STATE

Other names

  • Swinomish Wellness Program Doing business as

Other providers in La Conner, WA

All providers in La Conner, WA · Addiction (Substance Use Disorder) Counselor in Washington

Sources for this page

Verify at the official NPI Registry.