Provider Demographics
NPI:1134632599
Name:SWINOMISH HEALTH SERVICES
Entity type:Organization
Organization Name:SWINOMISH HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER - INTERIM
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KEYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-588-2800
Mailing Address - Street 1:8212 S MARCH POINT RD
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-8684
Mailing Address - Country:US
Mailing Address - Phone:360-588-2805
Mailing Address - Fax:360-588-2808
Practice Address - Street 1:8212 S MARCH POINT RD
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-8684
Practice Address - Country:US
Practice Address - Phone:360-588-2805
Practice Address - Fax:360-588-2808
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SWINOMISH INDIAN TRIBAL COMMUNITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-08
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadoneGroup - Single Specialty
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2091872Medicaid