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General NPI Number Information
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NPI Number | 1881568871
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Entity Type | Organization
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Legal Business Name | CONFEDERATED TRIBES OF THE COLVILLE RESERVATION
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Dates
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Enumeration Date | 10/02/2025
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Last Update Date | 10/02/2025
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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 | 509-634-2963
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Provider Business Mailing Address
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Address Line | PO BOX 150
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City | NESPELEM
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State | WA
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Zip | 99155-0150
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Country | US
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Telephone | 509-634-2900
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Fax | 509-634-2963
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Authorized Official
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Title or Position | REVENUE CYCLE DIRECTOR
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Name | AMY CHURCH
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Credential |
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Telephone | 509-634-2783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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