Provider Demographics
NPI:1568777688
Name:MAKAH TRIBE
Entity Type:Organization
Organization Name:MAKAH TRIBE
Other - Org Name:MAKAH MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-645-2628
Mailing Address - Street 1:201 RESORT DR
Mailing Address - Street 2:P.O. BOX 410
Mailing Address - City:NEAH BAY
Mailing Address - State:WA
Mailing Address - Zip Code:98357-0410
Mailing Address - Country:US
Mailing Address - Phone:360-645-2233
Mailing Address - Fax:360-645-2305
Practice Address - Street 1:201 RESORT DR
Practice Address - Street 2:
Practice Address - City:NEAH BAY
Practice Address - State:WA
Practice Address - Zip Code:98357-0410
Practice Address - Country:US
Practice Address - Phone:360-645-2233
Practice Address - Fax:360-645-2305
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOPHIE TRETTEVICK INDIAN HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health