340B Drug Pricing Program Database

Name

PORT GAMBLE S'KLALLAM TRIBE

Subdivision Name

Type

Tribal Contract/Compact with IHS (P.L. 93-638)

340B ID

FQHC638396

Current Program Status

Active

Registration Date

1/1/2001

Participating Start Date

1/1/2001

Participating Approval Date

8/19/2004

Last Recertification Date

2/18/2025

Authorizing Official

Port Gamble S'Klallam Tribe
Jolene Sullivan, Health Services Director
(360) 297-9619

Primary Contact

Port Gamble S'Klallam Tribe
Jacob Fundak, Deputy Health Business Manager
(360) 297-9649

Street Address

32020 LITTLE BOSTON ROAD NE - ADMIN ADDRESS
32020 LITTLE BOSTON ROAD NE - CLINIC ADDRESS
KINGSTON, WA 98346

Billing Address
Same as Street Address