Provider Demographics
NPI:1780559476
Name:QUINAULT INDIAN NATION
Entity type:Organization
Organization Name:QUINAULT INDIAN NATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING/CODING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:RUBY
Authorized Official - Middle Name:P
Authorized Official - Last Name:SAUNDERS-JEREMIAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:564-544-1950
Mailing Address - Street 1:421 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-6129
Mailing Address - Country:US
Mailing Address - Phone:564-544-1950
Mailing Address - Fax:564-544-1938
Practice Address - Street 1:114 N PARK ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-5919
Practice Address - Country:US
Practice Address - Phone:564-544-1950
Practice Address - Fax:564-544-1938
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUINAULT INDIAN NATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-10
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty