Provider Demographics
NPI:1659477644
Name:CLALLAM COUNTY HEALTH & HUMAN SERVICES
Entity Type:Organization
Organization Name:CLALLAM COUNTY HEALTH & HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:3604-172-2437
Mailing Address - Street 1:223 E 4TH ST
Mailing Address - Street 2:SUITE #14
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-3015
Mailing Address - Country:US
Mailing Address - Phone:360-417-2523
Mailing Address - Fax:360-417-2583
Practice Address - Street 1:223 E 4TH ST
Practice Address - Street 2:SUITE #14
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-3015
Practice Address - Country:US
Practice Address - Phone:360-417-2523
Practice Address - Fax:360-417-2583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8011504Medicaid