1083202907 NPI number — GRAYS HARBOR COUNTY PUBLIC HOSPITAL DISTRICT NO 1

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083202907 NPI number — GRAYS HARBOR COUNTY PUBLIC HOSPITAL DISTRICT NO 1

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GRAYS HARBOR COUNTY PUBLIC HOSPITAL DISTRICT NO 1
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083202907
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
GRAYS HARBOR PUBLIC HOSPITAL DISTRICT NO 1
Provider Second Line Business Mailing Address:
600 E MAIN STREET
Provider Business Mailing Address City Name:
ELMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98541
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-346-2222
Provider Business Mailing Address Fax Number:
360-346-2192

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
579 E MAIN ST
Provider Second Line Business Practice Location Address:
BLDG 2
Provider Business Practice Location Address City Name:
ELMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-346-2222
Provider Business Practice Location Address Fax Number:
360-346-2192
Provider Enumeration Date:
01/06/2021

Additional Information

Authorized Official

Authorized Official Last Name:
FIFIELD
Authorized Official First Name:
LYNN
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL STAFF SERVICES DIRECTOR
Authorized Official Telephone Number:
360-346-2222

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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