Swinomish Indian Tribal Community

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SWINOMISH INDIAN TRIBAL COMMUNITY

Practice address

17400 Reservation Rd
La Conner, WA 98257-8801

Phone

(360) 466-3167

Fax

(360) 466-5528

NPI assigned

Aug 7, 2007

Last updated

Aug 19, 2009By 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

Mrs. Cheryl Rasar

Title

Medical Biller

Phone

(360) 466-7268

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Swinomish Indian Tribal Community

  • Clinic/Center
  • La Conner, WA
  • NPI 1164483285

  O20090819000142

  Same enrollment

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250640000000",
    "number": "1376734111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 683",
            "city": "LA CONNER",
            "state": "WA",
            "postal_code": "982570683",
            "telephone_number": "360-466-3167",
            "fax_number": "360-466-5528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17400 RESERVATION RD",
            "city": "LA CONNER",
            "state": "WA",
            "postal_code": "982578801",
            "telephone_number": "360-466-3167",
            "fax_number": "360-466-5528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWINOMISH INDIAN TRIBAL COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2009-08-19",
        "status": "A",
        "authorized_official_last_name": "RASAR",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "MEDICAL BILLER",
        "authorized_official_telephone_number": "360-466-7268",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7215205",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Swinomish Health Clinic
• Swinomish Health Clinic
• Swinomish Health Clinic
• Swinomish Indian Tribal Community
• Swinomish Indian Tribal Community (Swinomish Wellness Program)
• Swinomish Indian Tribal Community (Swinomish Pharmacy)
• Swinomish Tribal Mental Health Program
• Swinomish Upper Skagit Dental
• Swinomish/Upper Skagit Dental Clinic
• Lisa M Taylor, MPT

• Primary Care Clinic/Center in La Conner, WA
• Providers in La Conner, WA by specialty
• Primary Care Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; 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.