Provider Demographics
NPI:1811878085
Name:SUQUAMISH TRIBAL
Entity type:Organization
Organization Name:SUQUAMISH TRIBAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:KUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:360-394-8552
Mailing Address - Street 1:PO BOX 1228
Mailing Address - Street 2:
Mailing Address - City:SUQUAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98392-1228
Mailing Address - Country:US
Mailing Address - Phone:360-394-5200
Mailing Address - Fax:360-598-1724
Practice Address - Street 1:9750 LEVIN RD NW
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8399
Practice Address - Country:US
Practice Address - Phone:360-698-3437
Practice Address - Fax:360-698-6600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, AmbulatoryGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty