Provider Demographics
NPI:1720811904
Name:SWINOMISH INDIAN TRIBAL COMMUNITY
Entity type:Organization
Organization Name:SWINOMISH INDIAN TRIBAL COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LAPOINTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-312-8288
Mailing Address - Street 1:11404 MOORAGE WAY
Mailing Address - Street 2:
Mailing Address - City:LA CONNER
Mailing Address - State:WA
Mailing Address - Zip Code:98257-9450
Mailing Address - Country:US
Mailing Address - Phone:360-588-2737
Mailing Address - Fax:
Practice Address - Street 1:17400 RESERVATION RD
Practice Address - Street 2:
Practice Address - City:LA CONNER
Practice Address - State:WA
Practice Address - Zip Code:98257-8801
Practice Address - Country:US
Practice Address - Phone:360-466-3167
Practice Address - Fax:360-466-5528
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SWINOMISH HEALTH CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy