NPIMap

Organization Active NPI

Washington State Department of Corrections Stafford Creek Corrections

  • Prison Health Clinic/Center
  • Aberdeen, WA
National Provider Identifier
1427349802
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prison Health Clinic/CenterTaxonomy code 261QP2400X
Legal business name
WASHINGTON STATE DEPARTMENT OF CORRECTIONS STAFFORD CREEK CORRECTIONS
Practice address
191 Constantine Way
Aberdeen, WA 98520
Phone
(360) 537-1800
Fax
(360) 537-2075
NPI assigned
Apr 20, 2011
Last updated
Sep 23, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
DEPARTMENT OF CORRECTIONSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Authorized official

Name
Mary Ann Curl, M.D.
Title
Chief Medical Officer
Phone
(509) 318-3498

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prison Health Clinic/Center 261QP2400X Primary

Addresses

Primary practice location

191 Constantine Way
Aberdeen, WA 98520

Mailing address

PO Box 41100, Mail Stop 41100
Olympia, WA 98504-1100
Phone (360) 725-8213

National Provider Directory

National Provider Directory
Tax ID family
Washington State Department of Corrections-Monroe Correctional Complex14 organizations share this tax ID, including this one
Part of
Washington State Department of Corrections-Monroe Correctional Complex

Other organizations with this tax ID 13

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

View all 13

Locations

191 Constantine Way
Aberdeen, WA 98520
Phone (360) 536-1800

NPI Registry JSON

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1427349802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41100, MAIL STOP 41100",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985041100",
            "telephone_number": "360-725-8213",
            "fax_number": "360-586-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 CONSTANTINE WAY",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "98520",
            "telephone_number": "360-537-1800",
            "fax_number": "360-537-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON STATE DEPARTMENT OF CORRECTIONS STAFFORD CREEK CORRECTIONS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEPARTMENT OF CORRECTIONS",
        "enumeration_date": "2011-04-20",
        "last_updated": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "CURL",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "509-318-3498",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.