NPIMap

Organization Active NPI

Jefferson County Public Hospital District No 2

Doing business as Jefferson Healthcare Surgical Associates

  • Critical Access Hospital
  • Port Townsend, WA
National Provider Identifier
1629492525
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
HAC.FS.00000085 Issued in WA
Legal business name
JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2
Doing business as
Jefferson Healthcare Surgical Associates
Practice address
1010 Sheridan St Ste 201
Port Townsend, WA 98368-2901
Phone
(360) 385-5444
Fax
(360) 385-5352
NPI assigned
Feb 12, 2014
Last updated
Dec 31, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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

Authorized official

Name
Mike Glenn
Title
Ceo
Phone
(360) 385-2200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X HAC.FS.00000085 WA Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

1010 Sheridan St Ste 201
Port Townsend, WA 98368-2901

Mailing address

PO Box 104546
Pasadena, CA 91189-4546
Phone (360) 385-2200

Other identifiers 2

IdentifierTypeStateIssuer
3301900MedicaidWA
1008579MedicaidWA

Other names 1

  • Jefferson Healthcare Surgical Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
G Forbes K Forbes MDS6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1392163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767139200000",
    "number": "1629492525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 104546",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911894546",
            "telephone_number": "360-385-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SHERIDAN ST STE 201",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682901",
            "telephone_number": "360-385-5444",
            "fax_number": "360-385-5352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-12",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "360-385-2200"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WA",
            "license": "HAC.FS.00000085",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3301900",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1008579",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson Healthcare Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Townsend, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; 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.