NPIMap

Organization Active NPI

Clinicare of Port Angeles Inc

  • Primary Care Clinic/Center
  • Port Angeles, WA
National Provider Identifier
1467610972
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
601555884 Issued in WA
Legal business name
CLINICARE OF PORT ANGELES INC
Practice address
621 E Front St
Port Angeles, WA 98362-3319
Phone
(360) 452-5000
Fax
(360) 452-0228
NPI assigned
May 30, 2008
Last updated
May 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2008

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

Authorized official

Name
Deck Dennis
Title
Clinic Manager
Phone
(360) 452-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 601555884 WA Primary

Addresses

Primary practice location

621 E Front St
Port Angeles, WA 98362-3319

Mailing address

621 E Front St
Port Angeles, WA 98362-3319
Phone (360) 452-5000

Other identifiers 2

IdentifierTypeStateIssuer
71530OtherWAWA STATE L&I
7065543MedicaidWA

National Provider Directory

National Provider Directory

Locations

621 E Front St
Port Angeles, WA 98362
Phone (360) 452-5000

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212105600000",
    "number": "1467610972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 E FRONT ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623319",
            "telephone_number": "360-452-5000",
            "fax_number": "360-452-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 E FRONT ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623319",
            "telephone_number": "360-452-5000",
            "fax_number": "360-452-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICARE OF PORT ANGELES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-05-30",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "DECK",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "360-452-5000"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WA",
            "license": "601555884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE L&I",
            "identifier": "71530",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7065543",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; 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.