Grays Harbor Public Hospital District No 1

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GRAYS HARBOR PUBLIC HOSPITAL DISTRICT NO 1

Practice address

600 E. Main Street
Elma, WA 98541

Phone

(360) 495-3500

Fax

(360) 495-4423

NPI assigned

Nov 9, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Renee K Jensen

Title

Ceo

Phone

(360) 346-2222

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mark Reed Healthcare Clinic Doing business as

Tax ID family

Grays Harbor County Public3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Grays Harbor County Public Hospital District No 1 Health Homes

  • Family Medicine Physician
  • Elma, WA
  • NPI 1043730021
  NPD tax ID
• Grays Harbor County Public Hospital District No. 1

  • Rural Health Clinic/Center
  • Elma, WA
  • NPI 1811025216
  NPD tax ID

Locations

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412208000000",
    "number": "1467522896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 S BIRCH ST",
            "city": "MCCLEARY",
            "state": "WA",
            "postal_code": "985579522",
            "telephone_number": "360-495-3500",
            "fax_number": "360-495-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E. MAIN STREET",
            "city": "ELMA",
            "state": "WA",
            "postal_code": "98541",
            "telephone_number": "360-495-3500",
            "fax_number": "360-495-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAYS HARBOR PUBLIC HOSPITAL DISTRICT NO 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2014-10-02",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "360-346-2222",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7104268",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mark Reed Healthcare Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Grays Harbor County Public Hospital District No 1
• Grays Harbor County Public Hospital District No 1
• Grays Harbor County Public Hospital District No 1 Health Homes
• Grays Harbor County Public Hospital District No. 1
• Grays Harbor County Public Hospital District No. 1
• Thomas Andrew Griffith, ND
• Ricardo Guadarrama Jr., LMHCA
• Brandy L Hahn, CDPT
• Gregory Hannabas, M.D.
• James Emmett Hansen

• All providers in Elma, WA
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.