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SUMMIT PACIFIC WELLNESS CLINIC
NPI 1811025216
Clinic/Center - Rural Health in Elma, WA

Active since February 28, 2007CLIA 50D2179849 · Waiver
610 E MAIN STREET, ELMA, WA 98541(360) 346-2222(360) 346-2163 Get Directions Write a Review

NPPES record last updated: January 18, 2019. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Summit Pacific Wellness Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUMMIT PACIFIC WELLNESS CLINIC (NPI 1811025216) is a healthcare organization registered as a rural health in Elma, Washington and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Renee K Jensen, Ceo, as its authorized official.

NPPES Registry Identity

NPI1811025216
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameGRAYS HARBOR COUNTY PUBLIC HOSPITAL DISTRICT NO. 1
Location Address610 E MAIN STREETElma, WA 98541-9551
Mailing Address600 E Main StElma, WA 98541-9560 · (360) 346-2222 · Fax (360) 346-2163
Phone(360) 346-2222
Fax(360) 346-2163
Organization SubpartYes
Authorized OfficialRenee K JensenCeo · (360) 495-3244
Enumeration DateFebruary 28, 2007
Last NPPES UpdateJanuary 18, 2019
✔ NPI 1811025216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
License✔ Licensed in WA · HAC.FS.00000186
Also ListedFamily MedicineTaxonomy 207Q00000X
610 E MAIN STREET, Elma, WA 98541
Open in Google Maps ↗

Other Names 1

Doing Business AsSummit Pacific Wellness Clinic

Other Identifiers 1

Medicaid7103815WA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Summit Pacific Wellness Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

138

Medicare enrollment records show 138 clinicians reassign Medicare billing to Summit Pacific Wellness Clinic, which bills Medicare for the services they deliver. Of these, 9 practice at this address and 29 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 21

Nurse Practitioner34
Emergency Medicine22
Internal Medicine18
Family Practice16
Gastroenterology8
Certified Registered Nurse Anesthetist (CRNA)7
Hospitalist6
Pediatric Medicine5
13 other specialties22

Nearest to this location (20)

See all 138
Marcus Heisler, M.D.
Family Practice
NPI 1205256955
610 E. MAIN STREET
Elma, WA 98541
(360) 346-2222
✔ PECOS✔ Accepts MedicareSame address
Laura Armstrong, M.D.
Family Practice
NPI 1497995823
610 E MAIN ST
Elma, WA 98541
(360) 346-2222
✔ PECOS✔ Accepts MedicareSame address
Edward Gonzalez, FNP-C
Nurse Practitioner
NPI 1689905952
610 E MAIN ST
Elma, WA 98541
(360) 346-2222
✔ PECOS✔ Accepts MedicareSame address
Rylan Hellstern
Marriage and Family Therapist
NPI 1366013229
610 E MAIN ST
Elma, WA 98541
(360) 346-2222
✔ PECOS✔ Accepts MedicareSame address
Amir Atabeygi, MD
Family Practice
NPI 1457791659
600 E MAIN ST
Elma, WA 98541
(360) 346-2222
✔ PECOS✔ Accepts MedicareSame address
Karissa Ellis, D.O.
Pediatric Medicine
NPI 1134486186
600 E MAIN ST
Elma, WA 98541
(360) 346-2222
✔ PECOSSame address
Katala Lach, ARNP
Nurse Practitioner
NPI 1669039384
600 E MAIN ST
Elma, WA 98541
(360) 495-5780
✔ PECOS✔ Accepts MedicareSame address
Emily Opp
Podiatry
NPI 1396207296
600 E MAIN ST
Elma, WA 98541
(360) 346-2222
✔ PECOS✔ Accepts MedicareSame address
Ayan Rage, M.D.
Gastroenterology
NPI 1629201173
600 E MAIN ST
Elma, WA 98541
(360) 338-3498
✔ PECOS✔ Accepts MedicareSame address
Shawn Andrews, M.D.
Family Practice
NPI 1194834267
575 E. MAIN STREET
Elma, WA 98541
(360) 482-3711
✔ PECOS✔ Accepts Medicare0.1 mi
Mary Biggerstaff, ARNP
Nurse Practitioner
NPI 1366775652
600 E. MAIN STREET
Elma, WA 98541
(360) 495-3244
✔ PECOS✔ Accepts Medicare0.8 mi
Sarah Bradford, NP-C
Nurse Practitioner
NPI 1609520592
600 E MAIN ST
Elma, WA 98541
(360) 346-2222
✔ PECOS0.8 mi
Laura Brownsmith, ARNP
Nurse Practitioner
NPI 1518545102
600 E MAIN ST
Elma, WA 98541
(360) 495-5791
✔ PECOS✔ Accepts Medicare0.8 mi
Kenneth Dietrich, M.D., MBA
Pediatric Medicine
NPI 1245288752
600 E MAIN ST
Elma, WA 98541
(360) 346-2240
✔ PECOS0.8 mi
Michael Fisher, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1831344852
600 E MAIN ST
Elma, WA 98541
(360) 346-2299
✔ Accepts Medicare0.8 mi
Gregory Hannabas, M.D.
Family Practice
NPI 1053792200
600 E MAIN ST
Elma, WA 98541
(360) 346-2222
✔ PECOS✔ Accepts Medicare0.8 mi
Marc Hartung
Orthopedic Surgery
NPI 1700381407
600 E MAIN ST
Elma, WA 98541
(360) 495-5647
✔ PECOS✔ Accepts Medicare0.8 mi
Brandee Haskin, PMHNP
Nurse Practitioner
NPI 1184359572
600 E MAIN ST
Elma, WA 98541
(360) 346-2222
✔ PECOS✔ Accepts Medicare0.8 mi
Claude Ouellette, LMHC
Mental Health Counselor
NPI 1023442514
600 E MAIN ST
Elma, WA 98541
(360) 346-2222
✔ PECOS✔ Accepts Medicare0.8 mi
John Ringquist, M.D.
Emergency Medicine
NPI 1851369318
600 E MAIN ST STE A
Elma, WA 98541
(360) 346-2222
✔ PECOS✔ Accepts Medicare0.8 mi
See all 138 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2179849

Summit Pacific Wellness Center · Elma, WA
Active · expires Apr 4, 2028
CLIA Number50D2179849
Laboratory TypeRural Health Clinic
Certificate Effective DateMarch 3, 2020
Certificate Expiration DateApril 4, 2028
Laboratory DirectorKelly Lloyd
Laboratory Phone(360) 346-2222
Laboratory LocationSummit Pacific Wellness Center610 E Main St, Elma, WA 98541
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grays Harbor County Public Hospital District No. 1's NPI number?

The NPI number for Grays Harbor County Public Hospital District No. 1 is 1811025216. It was assigned to this organization in the NPPES registry on February 28, 2007. The provider is doing business as Summit Pacific Wellness Clinic.

Where is Grays Harbor County Public Hospital District No. 1 located?

Grays Harbor County Public Hospital District No. 1 is located at 610 E Main Street, Elma, WA 98541. The listed phone number is (360) 346-2222.

What is Grays Harbor County Public Hospital District No. 1's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Is Grays Harbor County Public Hospital District No. 1 enrolled in Medicare?

Yes. Grays Harbor County Public Hospital District No. 1 is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Grays Harbor County Public Hospital District No. 1?

According to the CMS Revalidation Reassignment List (October 2026 release), 138 clinicians in 21 Medicare specialties reassign their Medicare billing to Grays Harbor County Public Hospital District No. 1. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (34), Emergency Medicine (22) and Internal Medicine (18). Of these, 9 practice at this address and 29 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Grays Harbor County Public Hospital District No. 1 hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2179849) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Grays Harbor County Public Hospital District No. 1 accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Grays Harbor County Public Hospital District No. 1 as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Grays Harbor County Public Hospital District No. 1 was last updated on January 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.