NPIMap

Organization Active NPI

Grays Harbor Community Hospital

Doing business as GHCH Westport Clinic

  • Rural Health Clinic/Center
  • Westport, WA
National Provider Identifier
1417733452
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GRAYS HARBOR COMMUNITY HOSPITAL
Doing business as
GHCH Westport Clinic
Practice address
801 N Montesano St
Westport, WA 98595
Phone
(866) 537-2778
NPI assigned
Sep 6, 2023
Last updated
Sep 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Niall Foley
Title
Cfo
Phone
(360) 537-5145

Specialties & licenses 1

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

Addresses

Primary practice location

801 N Montesano St
Westport, WA 98595

Mailing address

915 Anderson Dr
Aberdeen, WA 98520-1006
Phone (360) 537-5145

Other names 1

  • GHCH Westport Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240321003101 WA Part A Provider - Rural Health Clinic 3577462365 Practice locations: Westport, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417733452. Details of each certification follow.

Rural health clinic certification: CCN 508598

Legal name
GRAYS HARBOR COMMUNITY HOSPITAL
Doing business as
GHCH WESTPORT CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 24, 2025
Last certification
May 24, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1939 in WA
Enrollment address
801 N Montesano St
Ste 200
Westport, WA 98595
Related CCNs
500031

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Montesano Clinic10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Thomas Jensen Individual Corporate OfficerCeo Apr 16, 2018
W-2 Managing EmployeeCeo Apr 16, 2018
Niall Shea Foley Individual Corporate OfficerCfo Dec 1, 2018

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Grays Harbor Community HospitalAberdeen, WA, CCN 500031 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 2007
Jan 14, 2014
The Hoquiam ClinicHoquiam, WA, CCN 508577 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 16, 2018
GHCH Aberdeen East ClinicAberdeen, WA, CCN 508576 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 16, 2018
GHCH Montesano ClinicMontesano, WA, CCN 508575 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 16, 2018

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1417733452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 ANDERSON DR",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985201006",
            "telephone_number": "360-537-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N MONTESANO ST",
            "city": "WESTPORT",
            "state": "WA",
            "postal_code": "98595",
            "telephone_number": "866-537-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAYS HARBOR COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-08-11",
        "status": "A",
        "authorized_official_last_name": "FOLEY",
        "authorized_official_first_name": "NIALL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "360-537-5145"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GHCH Westport Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westport, WA

Sources for this page

Verify at the official NPI Registry.