Provider Demographics
NPI:1083202907
Name:GRAYS HARBOR COUNTY PUBLIC HOSPITAL DISTRICT NO 1
Entity Type:Organization
Organization Name:GRAYS HARBOR COUNTY PUBLIC HOSPITAL DISTRICT NO 1
Other - Org Name:SUMMIT PACIFIC HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL STAFF SERVICES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:FIFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-346-2222
Mailing Address - Street 1:GRAYS HARBOR PUBLIC HOSPITAL DISTRICT NO 1
Mailing Address - Street 2:600 E MAIN STREET
Mailing Address - City:ELMA
Mailing Address - State:WA
Mailing Address - Zip Code:98541
Mailing Address - Country:US
Mailing Address - Phone:360-346-2222
Mailing Address - Fax:360-346-2192
Practice Address - Street 1:579 E MAIN ST
Practice Address - Street 2:BLDG 2
Practice Address - City:ELMA
Practice Address - State:WA
Practice Address - Zip Code:98541
Practice Address - Country:US
Practice Address - Phone:360-346-2222
Practice Address - Fax:360-346-2192
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRAYS HARBOR COUNTY PUBLIC HOSPITAL DISTRICT NO 1
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-06
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health