OrganizationActive
Squaxin Island Medicaid Encounter
NPI 1114135779 · Clinic/Center · Shelton, WA
Squaxin Island Medicaid Encounter is a Clinic/Center organization in Shelton, WA (NPI 1114135779).
Provider details
- NPI number
- 1114135779
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Whitney Jones, Director(360) 427-9006
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
90 Se Klah Che Min Dr
Shelton, WA 98584-9216
Phone: (360) 427-9006
Street-level locationGet directions
Mailing address
90 Se Klah Che Min Dr
Shelton, WA 98584-9216
Other names (DBA / former)
- Other name
- Squaxin Island Tribe
Registry dates
- Enumerated
- 2007-05-18
- Last updated
- 2020-08-22
Frequently asked questions
- What is Squaxin Island Medicaid Encounter's NPI number?
- Squaxin Island Medicaid Encounter's National Provider Identifier (NPI) is 1114135779, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Squaxin Island Medicaid Encounter?
- Squaxin Island Medicaid Encounter is classified in the NPPES registry as Clinic/Center (Ambulatory Health Care Facilities).
- Where is Squaxin Island Medicaid Encounter located?
- Squaxin Island Medicaid Encounter's practice location on file with NPPES is 90 Se Klah Che Min Dr, Shelton, WA 98584-9216.
- What is Squaxin Island Medicaid Encounter's phone number?
- The practice phone number listed in the NPPES registry for Squaxin Island Medicaid Encounter is (360) 427-9006.
- Who is the authorized official for Squaxin Island Medicaid Encounter?
- The authorized official listed on Squaxin Island Medicaid Encounter's NPPES record is Whitney Jones, Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Squaxin Island Medicaid Encounter's NPI active?
- Yes — Squaxin Island Medicaid Encounter's NPI (1114135779) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.