| NPI | 1518585579 |
|---|---|
| Doing Business As | TRIBAL MEDICAID FQHC |
| Entity Type | Organization |
| Authorized Contact | KERSTIN M POWELL Health Services Business Manager 360-297-9649 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2020-07-07 |