SQUAXIN ISLAND HEALTH CLINIC NPI 1669532578
Clinic/Center in Shelton, WA

Organization Clinic/Center

About SQUAXIN ISLAND HEALTH CLINIC

Squaxin Island Health Clinic is a provider established in Shelton, Washington specializing in Clinic/center. The NPI number of Squaxin Island Health Clinic is 1669532578 and was assigned on December 2006. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 14 years ago. The provider's other name is Squaxin Island Health Clinic. The authorized official of this NPI record is Edward J. Fox Phd (Director Hhs)

NPI
1669532578
Provider NameSQUAXIN ISLAND HEALTH CLINIC
Provider Location Address90 SE KLAH CHE MIN DR SHELTON, WA 98584
Provider Mailing Address90 SE KLAH CHE MIN DR SHELTON, WA 98584
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameSQUAXIN ISLAND HEALTH CLINIC
Other Name TypeOther Name (5)
Enumeration Date12-11-2006
Last Update Date06-17-2008


Primary Taxonomy

Taxonomy Code261Q00000X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
License StateWA
Taxonomy DescriptionA facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Business Address

SQUAXIN ISLAND HEALTH CLINIC
90 SE KLAH CHE MIN DR
SHELTON, WA
ZIP 98584
Phone: (360) 427-9006
Fax: (360) 427-1951

Get Directions


Mailing Address

SQUAXIN ISLAND HEALTH CLINIC
90 SE KLAH CHE MIN DR
SHELTON, WA
ZIP 98584
Phone: (360) 427-9006
Fax: (360) 427-1951


Authorized Official

Authorized Official Name EDWARD J. FOX PHD
Authorized Official TitleDIRECTOR HHS
Authorized Official Phone(360) 427-9006

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
7003767MEDICAID (05)WA
7047772MEDICAID (05)WA
1980994MEDICAID (05)WA

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1669532578
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
261291034514
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 1 + 2 + 9 + 1 + 0 + 3 + 4 + 5 + 1 + 4 + 24 = 62
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 62 = 88

The NPI number 1669532578 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 15 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1821113119MR. CHARLES TIFFANY BARRET P.A.-C.
Individual
Physician Assistant (Medical)90 SE KLAH CHE MIN DR
SHELTON, WA 98584
(360) 427-9006
1588782247MS. MICHELLE LOUISE WILEY RDH
Individual
Dental Hygienist90 SE KLAH CHE MIN DR
SHELTON, WA 98584
(360) 427-9006
1205007762 BRENDA DORSEY MSW, LMHC
Individual
Counselor (Mental Health)90 SE KLAH CHE MIN DR
SHELTON, WA 98584
(360) 432-3921
1114184579MISS SUSAN ROWSON MA
Individual
Counselor90 SE KLAH CHE MIN DR
SHELTON, WA 98584
(360) 432-3896
1063647923MS. PAMELA LYNN PETERS RN
Individual
Registered Nurse90 SE KLAH CHE MIN DR
SHELTON, WA 98584
(360) 427-9006
1619241882 DOUGLAS REITSCH RPH
Individual
Pharmacist90 SE KLAH CHE MIN DR
SHELTON, WA 98584
(360) 432-3990
1316329980 JONATHAN CORBIN WILTON M.D.
Individual
Family Medicine90 SE KLAH CHE MIN DR
SHELTON, WA 98584
(360) 427-9006
1386263820MRS. DENEICE GURRAD RPH
Individual
Pharmacist90 SE KLAH CHE MIN DR
SHELTON, WA 98584
(360) 432-3990
1619180981SQUAXIN ISLAND MEDICAL ENCOUNTER
Organization
Clinic/Center (Health Service)90 SE KLAH CHE MIN DR
SHELTON, WA 98584
(360) 427-9006
1255546578SQUAXIN ISLAND DENTAL CLINIC FFS
Organization
Clinic/Center (Dental)90 SE KLAH CHE MIN DR
SHELTON, WA 98584
(360) 427-9006
1003021338SQUAXIN ISLAND DENTAL CLINIC ENCOUNTER
Organization
Clinic/Center (Dental)90 SE KLAH CHE MIN DR
SHELTON, WA 98584
(360) 427-9006
1912112244SQUAXIN ISLAND CHEMICAL DEPENDENCY ENCOUNTER
Organization
Clinic/Center (Rehabilitation, Substance Use Disorder)90 SE KLAH CHE MIN DR
SHELTON, WA 98584
(360) 427-9006
1114135779SQUAXIN ISLAND MEDICAID ENCOUNTER
Organization
Clinic/Center90 SE KLAH CHE MIN DR
SHELTON, WA 98584
(360) 427-9006
1598973158SQUAXIN ISLAND MEDICAL ENCOUNTER
Organization
Clinic/Center (Health Service)90 SE KLAH CHE MIN DR
SHELTON, WA 98584
(360) 427-9006
1437825692 RAYLEEN DENISE KIRKLAND PAC
Individual
Physician Assistant90 SE KLAH CHE MIN DR
SHELTON, WA 98584
(360) 427-9006

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Squaxin Island Health Clinic is registered as an entity type code: 2. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.