NPIMap

Organization Active NPI

Puyallup Tribal Health Authority

  • Adult Mental Health Clinic/Center
  • Tacoma, WA
National Provider Identifier
1255378782
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
PUYALLUP TRIBAL HEALTH AUTHORITY
Doing business as
Puyallup Tribal Health Authority
Practice address
2209 E 32ND St
Tacoma, WA 98404
Phone
(253) 593-0232
Fax
(253) 382-2091
NPI assigned
Jun 1, 2006
Last updated
Jul 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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

Authorized official

Name
Mrs. Chris Henry
Title
Executive Director
Phone
(253) 593-0232

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

2209 E 32ND St
Tacoma, WA 98404

Mailing address

2209 E 32ND St
P.O. Box 8009
Tacoma, WA 98404-4922
Phone (253) 593-0232

Other identifiers 2

IdentifierTypeStateIssuer
1980762MedicaidWA
366486002OtherWAGROUP HEALTH OPTIONS

Other names 2

  • PUYALLUP TRIBAL HEALTH AUTHORITY Doing business as
  • KWAWACHEE COUNSELING CENTER Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040309001482 WA Part B Supplier - Clinic/Group Practice 9436047537 Receives reassigned benefits from 57 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tacoma, 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
Puyallup Tribal HLTH Auth3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 51

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 51

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531440000000",
    "number": "1255378782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 E 32ND ST",
            "address_2": "P.O. BOX 8009",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984044922",
            "telephone_number": "253-593-0232",
            "fax_number": "253-382-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 E 32ND ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98404",
            "telephone_number": "253-593-0232",
            "fax_number": "253-382-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUYALLUP TRIBAL HEALTH AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2018-07-13",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "253-593-0232",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1980762",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH OPTIONS",
            "identifier": "366486002",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PUYALLUP TRIBAL HEALTH AUTHORITY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KWAWACHEE COUNSELING CENTER",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "KWAWACHEE COUNSELING CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; 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.