Clallam County Jail Medical

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

CLALLAM COUNTY JAIL MEDICAL

Practice address

223 E 4TH St
Suite 12
Port Angeles, WA 98362-3000

Phone

(360) 417-2592

NPI assigned

Oct 22, 2008

Organization subpart

No

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

Authorized official

Name

Karen E Peterson

Title

Fiscal Specialist

Phone

(360) 417-2592

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Tax ID family

Clallam County Clinical Services3 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.

• Clallam County Clinical Services

  • Prison Health Clinic/Center
  • Port Angeles, WA
  • NPI 1841132404
  NPD tax ID
• Clallam County Juvenile and Family Services

  • Rehabilitation Clinic/Center
  • Port Angeles, WA
  • NPI 1326139528
  NPD tax ID

Practitioners 1

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

• Tamara Stone Vanover, MS

  • Case Manager/Care Coordinator
  • Port Angeles, WA
  • NPI 1972258861
  NPD (past)

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224633600000",
    "number": "1518119403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 E 4TH ST",
            "address_2": "SUITE 12",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623000",
            "telephone_number": "360-417-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 E 4TH ST",
            "address_2": "SUITE 12",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623000",
            "telephone_number": "360-417-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLALLAM COUNTY JAIL MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-22",
        "last_updated": "2008-10-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "FISCAL SPECIALIST",
        "authorized_official_telephone_number": "360-417-2592"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clallam Anesthesiologist Associated PLLC
• Clallam County Clinical Services
• Clallam County Fire Prot Dist 4
• Clallam County Fire Protection District No 2
• Clallam County Health & Human Services
• Clallam County Juvenile and Family Services
• Clallam County Public Hospital District 2
• Clallam County Public Hospital District 2
• Clallam County Public Hospital District 2
• Fallon Ann Clancy, PA

• Public Health or Welfare Agency in Port Angeles, WA
• Providers in Port Angeles, WA by specialty
• Public Health or Welfare Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; 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.