NPIMap

Organization Active NPI

Quileute Counseling and Recovery Substance Use Disorder

  • Addiction (Substance Use Disorder) Counselor
  • Forks, WA
National Provider Identifier
1861950859
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
QUILEUTE COUNSELING AND RECOVERY SUBSTANCE USE DISORDER
Doing business as
Quileute Counseling and Recovery Substance Use Disorder
Practice address
579 Hermison Rd
Forks, WA 98331
Phone
(360) 374-9035
Fax
(360) 374-5448
NPI assigned
Mar 8, 2019
Last updated
Jun 10, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
QUILEUTE TRIBAL COUNCILAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Authorized official

Name
Gary Bryan Goodwin
Title
Billing Agency
Phone
(360) 867-0709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU Primary

Addresses

Primary practice location

579 Hermison Rd
Forks, WA 98331

Mailing address

PO Box 189
La Push, WA 98350-0189
Phone (360) 374-3358

Other names 1

  • Quileute Counseling and Recovery Substance Use Disorder Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Quileute Tribal Council4 organizations share this tax ID, including this one
Part of
Quileute Tribal Council

Other organizations with this tax ID 3

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": "1552003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781049600000",
    "number": "1861950859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "LA PUSH",
            "state": "WA",
            "postal_code": "983500189",
            "telephone_number": "360-374-3358",
            "fax_number": "360-374-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 HERMISON RD",
            "city": "FORKS",
            "state": "WA",
            "postal_code": "98331",
            "telephone_number": "360-374-9035",
            "fax_number": "360-374-5448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUILEUTE COUNSELING AND RECOVERY SUBSTANCE USE DISORDER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUILEUTE TRIBAL COUNCIL",
        "enumeration_date": "2019-03-08",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "BILLING AGENCY",
        "authorized_official_telephone_number": "360-867-0709"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quileute Counseling and Recovery Substance Use Disorder",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Forks, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; 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.