NPIMap

Organization Active NPI

County of Pacific

  • Public Health or Welfare Agency
  • South Bend, WA
National Provider Identifier
1508081217
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
COUNTY OF PACIFIC
Doing business as
Pacific County Public Health and Human Service Department
Practice address
1216 West Robert Bush Drive
South Bend, WA 98586
Phone
(360) 875-9343
Fax
(360) 875-9323
NPI assigned
Apr 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Authorized official

Name
Gracie E Minks
Title
Deputy Director
Phone
(360) 214-6087

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

1216 West Robert Bush Drive
South Bend, WA 98586

Mailing address

PO Box 26
South Bend, WA 98586-0026
Phone (360) 875-9343

Other practice location 1

7013 Sandridge Rd
Long Beach, WA 98631-4703
Phone (360) 642-9323

Other identifiers 4

IdentifierTypeStateIssuer
7902703MedicaidWA
7400930MedicaidWA
7403801MedicaidWA
7261308MedicaidWA

Other names 1

  • Pacific County Public Health and Human Service Department Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D0671737Pacific County HHS Department1216 W Robert Bush Dr, South Bend, WA 98586Provider-performed microscopyApr 4, 2028

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

7013 Sandridge Rd
Long Beach, WA 98631
Phone (360) 642-9323

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724371200000",
    "number": "1508081217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26",
            "city": "SOUTH BEND",
            "state": "WA",
            "postal_code": "985860026",
            "telephone_number": "360-875-9343",
            "fax_number": "360-875-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 WEST ROBERT BUSH DRIVE",
            "city": "SOUTH BEND",
            "state": "WA",
            "postal_code": "98586",
            "telephone_number": "360-875-9343",
            "fax_number": "360-875-9323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7013 Sandridge Rd",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "WA",
            "postal_code": "986314703",
            "country_code": "US",
            "telephone_number": "360-642-9323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COUNTY OF PACIFIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A",
        "authorized_official_last_name": "MINKS",
        "authorized_official_first_name": "GRACIE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR",
        "authorized_official_telephone_number": "360-214-6087"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7902703",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7400930",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7403801",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7261308",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific County Public Health and Human Service Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Bend, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.