CLALLAM COUNTY PUBLIC HOSPITAL DISTRICT NO1 (NPI# 1285683052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285683052 |
| Entity Type | Organization |
| Organization Name | CLALLAM COUNTY PUBLIC HOSPITAL DISTRICT NO1 |
| Other Organization Name | BOGACHIEL CLINIC |
| Practice Address |
390 Founders Way Forks WA 98331-9062 |
| Mailing Address |
390 Founders Way Forks WA 98331 |
| Practice Telephone | 3603746271 |
| Practice Fax Number | 3603749781 |
| Mailing Telephone | 3603746271 |
| Mailing Fax Number | 3603749781 |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2016-12-14 |
| Authorized Official Name | STARLA D DAMAN (BILLING MANAGER) |
| Authorized Official Telephone | 3603746271 |
| Is Organization Subpart | Y |
| Parent Organization Name | CLALLAM COUNTY PUBLIC HOSPITAL DISTRICT NO 1 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
H-054 | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7113442 | 05 | |
| WA | 7047459 | 05 |
| Other Name | Type Code |
|---|---|
| Bogachiel Clinic | Doing Business As Name - Organization |
| Street Address |
390 FOUNDERS WAY |
| City | FORKS |
| State | WA |
| Zip Code | 98331-9062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801350673 | Stephanie Marie Bechtold | Nurse Practitioner | 390 Founders Way, Forks, WA 98331-9062 | 2019-01-25 |
| 1285861989 | Shannon L. Servin-obert | Family Medicine | 390 Founders Way, Forks, WA 98331-9062 | 2009-06-19 |
| 1366456832 | Susan Lee Shane | Registered Nurse | 390 Founders Way, Suite 1, Forks, WA 98331-9062 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518509520 | Sasha Rose Jensen | Nurse Practitioner | 460 West G Street, Forks, WA 98331 | 2019-10-10 |
| 1497298046 | Cathy A. Clark L.m.p. | Massage Therapist | 186-375 Hwy. 101, Forks, WA 98331 | 2016-11-30 |
| 1841447752 | Concerned Citizens | Early Intervention Provider Agency | 945 S Forks Ave, Forks, WA 98331 | 2008-08-21 |
| 1720276207 | Richard L. Dickson | Clinic/Center | 481 West E St, Forks, WA 98331 | 2007-10-09 |
| 1508078627 | John M Shima Md Ps | Internal Medicine | 460 West E St, Forks, WA 98331 | 2007-05-03 |
| 1578612875 | Anea Beck Ownes | Massage Therapist | 230 Willow Ave, Forks, WA 98331 | 2007-01-09 |
| 1295820173 | Howard Edward Berris | Dentist | 37325 W 12 Mile Rd, Suite B, Farmington Hills, MI 98331 | 2006-10-04 |
| 1760455075 | Richard Lee Dickson | Family Medicine | 481 W E St, Forks, WA 98331 | 2006-02-08 |
| 1700382843 | Vernon Rondeau | Registered Nurse | 560 Quileute Heights, La Push, WA 98331 | 2018-04-05 |
| 1962769760 | Anand Selvam | Emergency Medicine | 530 Bogachiel Way, Forks, WA 98331 | 2012-04-18 |
| Find all providers in zip 98331 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720276207 | Richard L. Dickson | Clinic/Center | 481 West E St, Forks, WA 98331 | 2007-10-09 |
| 1255616579 | Harrison Medical Center | Clinic/Center | 461 G St, Forks, WA 98331-9025 | 2011-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811555931 | Okanogan County Public Hospital Dist No 4 | Clinic/Center | 118 N Whitcomb Ave, Tonasket, WA 98855-8803 | 2019-06-04 |
| 1790204154 | Sunnyside Community Hospital Association | Clinic/Center | 715 N Park Ctr, Selah, WA 98942-1174 | 2017-09-15 |
| 1699215384 | Sunnyside Community Hospital Association | Clinic/Center | 505 W 4th Ave, Toppenish, WA 98948-1615 | 2017-03-01 |
| 1609112739 | Grant County Public Hospital District. No. 1 | Clinic/Center | 8420 Aspi Blvd, Moses Lake, WA 98837-1820 | 2012-12-18 |
| 1801188073 | Jefferson County Public Hospital District No 2 | Clinic/Center | 89 Breaker Ln, Port Ludlow, WA 98365-9766 | 2011-05-06 |
| 1255651907 | Family Care Network Pllc | Clinic/Center | 2511 M Ave Ste A, Anacortes, WA 98221-3897 | 2010-06-04 |
| 1871822676 | Public Hospital District 3 of Pacific County | Clinic/Center | 167 1st Avenue North, Ilwaco, WA 98624-0319 | 2009-12-08 |
| 1316138720 | L. Keith Hanson Pllc | Clinic/Center | 520 W. Indian Avenue, Brewster, WA 98812 | 2007-08-09 |
| 1407055742 | San Juan Healthcare PC | Clinic/Center | 689 Airport Center Dr Suite B, Friday Harbor, WA 98250 | 2007-07-17 |
| 1780897074 | Jefferson County Public Hospital District No 2 | Clinic/Center | 294843 State Highway 101, Quilcene, WA 98376 | 2007-05-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.