NISQUALLY INDIAN TRIBE


Address: 4816 She Nah Num Dr Se, Olympia, WA 98513-9105
Phone: 3604595312

NISQUALLY INDIAN TRIBE (NPI# 1952623027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952623027
Entity Type Organization
Organization Name NISQUALLY INDIAN TRIBE
Other Organization Name NISQUALLY TRIBAL PHARMACY
Practice Address 4816 She Nah Num Dr Se
Olympia
WA 98513-9105
Practice Telephone 3604595312
Practice Fax Number 3604561557
Mailing Telephone 3604595312
Mailing Fax Number 3604561557
Enumeration Date 2010-02-17
Last Update Date 2010-02-17
Authorized Official Name LARRY LAMEBULL (HEALTH ADMINISTRATOR, NISQUALL)
Authorized Official Telephone 3604565221
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
NCPDP PROVIDER IDENTIFICATION NUMBER 4933645 01

Other Provider/Organization Names

Other Name Type Code
Nisqually Tribal Pharmacy Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1477745925 Nisqually Indian Tribe Clinic/Center 4816 She Nah Num Dr Se, Olympia, WA 98513-9105 2007-08-17

Office Location

Street Address 4816 SHE NAH NUM DR SE
City OLYMPIA
State WA
Zip Code 98513-9105

Providers in the same location

NPI Name Taxonomy Address Enumeration
1215934054 Alison J Spencer Family Medicine 4816 She Nah Num Dr Se, Olympia, WA 98513-9105 2005-07-07
1205382504 Richelle Kistler Pharmacist 4816 She Nah Num Dr Se, Olympia, WA 98513-9105 2016-08-28
1356715882 Anita Frances Torres Counselor 4816 She Nah Num Dr Se, Olympia, WA 98513-9105 2015-11-20
1215324918 Robert Rodgers Counselor 4816 She Nah Num Dr Se, Olympia, WA 98513-9105 2015-04-20
1467857573 Francis Caclda Clinic/Center 4816 She Nah Num Dr Se, Olympia, WA 98513-9105 2014-10-31
1790190858 Cynthia Gallegos Registered Nurse 4816 She Nah Num Dr Se, Olympia, WA 98513-9105 2014-06-27
1508161050 Diane R Barres Pharmacist 4816 She Nah Num Dr Se, Olympia, WA 98513-9105 2011-01-13
1992938575 Scot L Metcalfe Counselor 4816 She Nah Num Dr Se, Olympia, WA 98513-9105 2009-08-28
1023245149 Jennifer L Caldwell-hoskins Counselor 4816 She Nah Num Dr Se, Olympia, WA 98513-9105 2009-06-16
1467612440 Roni Ann Rave Specialist 4816 She Nah Num Dr Se, Olympia, WA 98513-9105 2008-06-12
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1760095962 Katrina-nadine Maanao Perez Occupational Therapist Meadows Elementary School, 836 Deerbrush Drive Se, Lacey, WA 98513 2020-08-26
1679056824 Katharine Loco-marshall Physician Assistant 4816 She-nah-num Drive, Olympia, WA 98513 2018-09-13
1881113439 Riley Cruz Massage Therapist 10135 Stedman Rd Se, Olympia, WA 98513 2017-09-14
1174071948 Kirby Healthcare, LLC Nursing Care 244 Dutterow Rd Se, Olympia, WA 98513 2016-09-21
1477980134 Angela Karr Pharmacist 4918 Balustrade Blvd Se, Lacey, WA 98513 2013-09-26
1174875876 Sheila Lynn Emmons Massage Therapist 8321 Valley Green Dr., Olympia, WA 98513 2012-10-05
1407081391 Nicole Justine Adamson Chiropractor 4631 Whitman Lane, Suite B, Lacey, WA 98513 2009-05-20
1568628410 Molly Carolyn Ostrander Counselor 5026 70th Way South East, Lacey, WA 98513 2008-07-31
1063674430 Wayne Lawrence Franks Counselor 4816 She-nah-num Drive Se, Nisqually Indiantribe, Olympia, WA 98513 2008-06-27
1356521405 Mikki R Bosman Massage Therapist 5515 93rd Ave Se, Olympia, WA 98513 2007-11-06
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Taxonomy Information

Taxonomy Code 332800000X
Grouping Suppliers
Classification Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

Taxonomy Definition

An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603.
Notes: Source: The Medicare Prescription Drug, Improvement and Modernization Act of 2003 [1/1/2006: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1184135808 Alliance Healthcare Technolgies Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 1781 267th Ct Se, Sammamish, WA 98075 2017-10-20
1427171628 Roger Saux Health Center Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 1505 Klaookwa Drive, Taholah, WA 98587 2007-04-10
1265556005 Department of Health and Human Services Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 29 Nespelem San Poil Street, Nespelem, WA 99155-0071 2007-03-19
1679607956 Omak Tribal Health Clinic Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 29 Nespelem Sanpoil St, Nespelem, WA 99155-0071 2007-03-16
1750411310 David C Wynecoop Memorial Clinic Pharmacy Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy Agency Square, Wellpinit, WA 99040 2007-03-06
1063542645 Colville Indian Health Center Pharmacy Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy Agency Campus Hwy 155, Nespelem, WA 99155 2007-03-06
1487105482 Native Project Pharmacy Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 1803 W Maxwell Ave, Spokane, WA 99201-2831 2016-10-14
1881142214 Confederated Tribes of The Chehalis Reservation Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 21 Niederman Rd, Oakville, WA 98568-8904 2016-09-14
1699184366 The Native Project Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 1803 W Maxwell Ave, Spokane, WA 99201-2831 2014-08-07
1225241581 Muckleshoot Health and Wellness Center Pharmacy Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 17500 Se 392nd St, Attn Pharmacy, Auburn, WA 98092-9705 2007-05-07
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Competitor

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City OLYMPIA
Zip Code 98513

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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