Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Snoqualmie Indian Tribe

Organization Public Health & General Preventive Medicine Physician · NPI 1043873722

Snoqualmie Indian Tribe is a Public Health & General Preventive Medicine Physician in Snoqualmie, Washington. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
3

Practice location Address checks out

9575 Ethan Wade Way SE
Snoqualmie, WA 98065-9577
Phone: (425) 831-5425
Fax: (425) 831-5428
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Public Health & General Preventive Medicine Physician (primary) Taxonomy 2083P0901X
Mental Health Clinic/Center (Including Community Mental Health Center) Taxonomy 261QM0801X
Substance Use Disorder Rehabilitation Clinic/Center Taxonomy 261QR0405X

Record details

NPI number1043873722
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jean Medina — Compliance Manager · (425) 831-5425
NPI enumeratedApril 17, 2019
Last updated in NPPESJuly 25, 2022
Certification dateJuly 25, 2022
Mailing addressPo Box 969, Attn Compliance Manager, Snoqualmie, WA 98065-0969