Jefferson Healthcare

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

PH 60291084 Issued in WA

Legal business name

JEFFERSON HEALTHCARE

Practice address

834 Sheridan St
Department of Pharmacy
Port Townsend, WA 98368-2443

Phone

(360) 385-2200

Fax

(360) 385-6925

NPI assigned

Jan 19, 2015

Last updated

Jan 19, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mike Glenn

Title

Ceo

Phone

(360) 385-2200

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1421625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421625600000",
    "number": "1346639051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 SHERIDAN ST",
            "address_2": "DEPARTMENT OF PHARMACY",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682443",
            "telephone_number": "360-385-2200",
            "fax_number": "360-385-6925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 SHERIDAN ST",
            "address_2": "DEPARTMENT OF PHARMACY",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682443",
            "telephone_number": "360-385-2200",
            "fax_number": "360-385-6925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-19",
        "last_updated": "2015-01-19",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "360-385-2200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "WA",
            "license": "PH 60291084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "PH 60291084",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jefferson County Public Hospital District No 2 (Jefferson Healthcare Surgical Associates)
• Jefferson County Public Hospital District No 2 (Jefferson Healthcare Watership Clinic)
• Jefferson County Public Hospital District No 2 (Jefferson Healthcare Sheridan Clinic)
• Jefferson County Public Hospital District No 2 (Jefferson Healthcare Townsend Clinic)
• Jefferson Family Pharmacy Inc.
• Jefferson Orthopedic Group (Alan Greenwald MD)
• Jofran Enterprises, Inc.
• Amy Johnson, LMFTA
• Hazel Irene Johnson, LMHC
• Lenora Ann Johnson, AAC

• General Acute Care Hospital in Port Townsend, WA
• Providers in Port Townsend, WA by specialty
• General Acute Care Hospital in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.