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General NPI Number Information
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NPI Number | 1679607956
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Entity Type | Organization
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Legal Business Name | OMAK TRIBAL HEALTH CLINIC
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 617 BENTON ST
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City | OMAK
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State | WA
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Zip | 98841-9636
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Country | US
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Telephone | 509-634-2900
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Fax | 509-634-2990
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Provider Business Mailing Address
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Address Line | 617 BENTON ST
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City | OMAK
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State | WA
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Zip | 98841-9636
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Country | US
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Telephone | 509-634-2900
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Fax | 509-634-2990
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Authorized Official
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Title or Position | ACTING CEO
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Name | YVONNE IVERSON
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Credential |
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Telephone | 509-634-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332800000X
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Taxonomy Name | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
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License Number |
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License Number State |
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