PROVIDENCE HEALTH & SERVICES - WASHINGTON
NPI 1073677605
Rehabilitation, Substance Use Disorder Unit in Shelton, WA
NPI Status: Active since December 20, 2006
Contact Information
506 W FRANKLIN ST
SHELTON, WA
ZIP 98584
Phone: (360) 432-8692
- Organization
- Rehabilitation, Substance Use Disorder U...
- CLIA Number: 50D2317681
- CLIA Cert. Type: Hospice
- CLIA Exp. Date: 04-04-2028
About PROVIDENCE HEALTH & SERVICES - WASHINGTON
This page provides the complete NPI Profile along with additional information for Providence Health & Services - Washington, a provider established in Shelton, Washington operating as a Rehabilitation, Substance Use Disorder Unit. The healthcare provider is registered in the NPI registry with number 1073677605 assigned on December 2006. The practitioner's primary taxonomy code is 276400000X. The provider is registered as an organization and their NPI record was last updated May 2025. The provider's
- NPI
- 1073677605
- Provider Legal Name
- PROVIDENCE HEALTH & SERVICES - WASHINGTON
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 506 W FRANKLIN ST SHELTON, WA 98584
- Location Phone
- (360) 432-8692
- Mailing Address
- 909 N BROADWAY PBO/CREDENTIALING EVERETT, WA 98201
- Mailing Phone
- (425) 317-0246
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-20-2006
- Last Update Date
- 05-13-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Rehabilitation, Substance Use Disorder Unit
- Taxonomy Code
- 276400000X
- Type
- Hospital Units
- Taxonomy Description
- A distinct part of a hospital that provides medically monitored, interdisciplinary addiction-focused treatment to patients/clients who have psychoactive substance use disorders (commonly referred to as alcohol and drug abuse or substance abuse.)
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 50D2317681
- Facility Type
- Hospice
- Certificate Effective Date
- January 29, 2025
- Certificate Expiration Date
- April 04, 2028
- Laboratory Director
- TINA FORGEY
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Providence Health & Services - Washington to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 7 | 3 | 6 | 7 | 7 | 6 | 0 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 14 | 3 | 12 | 7 | 14 | 6 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 4 + 3 + 1 + 2 + 7 + 1 + 4 + 6 + 0 + 24 = 55 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 55 = 5 | 5 | ||||||||
The NPI number 1073677605 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 9 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1619438793 | JANICE M DICKINSON Individual | Case Manager/Care Coordinator | 506 W FRANKLIN ST SHELTON, WA 98584 (360) 427-5232 |
| 1821658766 | JULIE ANN BROWN Individual | Counselor (Addiction (Substance Use Disorder)) | 506 W FRANKLIN ST SHELTON, WA 98584 (360) 427-5232 |
| 1083825764 | NEW DIRECTIONS COUNSELING, LLC Organization | Community/Behavioral Health | 506 W FRANKLIN ST SHELTON, WA 98584 (360) 427-5232 |
| 1679034748 | SCOTT MICHAEL DICKINSON SUDP Individual | Counselor (Addiction (Substance Use Disorder)) | 506 W FRANKLIN ST SHELTON, WA 98584 (360) 427-5232 |
| 1477014561 | MACHEL M LEDFORD SUDP Individual | Counselor (Addiction (Substance Use Disorder)) | 506 W FRANKLIN ST SHELTON, WA 98584 (360) 427-5232 |
| 1891362018 | KIMBERLY BARRAGAN SUDPT Individual | Counselor | 506 W FRANKLIN ST SHELTON, WA 98584 (360) 427-5232 |
| 1245846252 | JUDALYN EVETTE GILL SUDPT, AAC, CPC Individual | Counselor | 506 W FRANKLIN ST SHELTON, WA 98584 (360) 427-5232 |
| 1255020244 | JUAN SOTO AAC, CPC Individual | Peer Specialist | 506 W FRANKLIN ST SHELTON, WA 98584 (360) 427-5232 |
| 1063453314 | JENNIFER VANDEGRAFT MS, AAC, MHP, CCM Individual | Counselor | 506 W FRANKLIN ST SHELTON, WA 98584 (360) 427-5232 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1073677605, enumerated in the NPI registry as an "organization" on December 20, 2006
The provider is located at 506 W Franklin St Shelton, Wa 98584 and the phone number is (360) 432-8692
This medical organization specializes in Rehabilitation, Substance Use Disorder Unit with taxonomy code 276400000X
The provider's CLIA number is 50D2317681 for a "hospice" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on December 20, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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