NPIMap

Organization Active NPI

San Juan Healthcare Associates PLLC

  • Rural Health Clinic/Center
  • Friday Harbor, WA
National Provider Identifier
1356326565
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SAN JUAN HEALTHCARE ASSOCIATES PLLC
Practice address
689 Airport Center
Ste B
Friday Harbor, WA 98250
Phone
(360) 378-1338
Fax
(360) 378-1830
NPI assigned
Dec 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
John Burk Gossom, M.D.NPI 1245221886
Title
Member Manager
Phone
(360) 378-1338

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

689 Airport Center
Ste B
Friday Harbor, WA 98250

Mailing address

PO Box 1550
Friday Harbor, WA 98250-1550
Phone (360) 378-1338

Other identifiers 5

IdentifierTypeStateIssuer
8937841OtherCRIME VICTIMS
0152516OtherLABOR AND INDUSTRIES
7108681OtherDSHS MEDICAID
9451SAOtherREGENCE BLUE SHIELD
J5122OtherRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

689 Airport Circle Dr
#8
Friday Harbor, WA 98250
Phone (360) 378-1338

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1356326565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1550",
            "city": "FRIDAY HARBOR",
            "state": "WA",
            "postal_code": "982501550",
            "telephone_number": "360-378-1338",
            "fax_number": "360-378-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "689 AIRPORT CENTER",
            "address_2": "STE B",
            "city": "FRIDAY HARBOR",
            "state": "WA",
            "postal_code": "98250",
            "telephone_number": "360-378-1338",
            "fax_number": "360-378-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUAN HEALTHCARE ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-09",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "GOSSOM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "BURK",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "360-378-1338",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8937841",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0152516",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS MEDICAID",
            "identifier": "7108681",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "9451SA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "J5122",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Friday Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.