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General NPI Number Information
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NPI Number | 1952623027
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Entity Type | Organization
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Legal Business Name | NISQUALLY INDIAN TRIBE
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Dates
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Enumeration Date | 02/17/2010
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 4840 JOURNEY ST SE
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City | OLYMPIA
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State | WA
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Zip | 98513-6779
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Country | US
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Telephone | 360-491-9770
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Fax | 360-486-9556
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Provider Business Mailing Address
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Address Line | 4840 JOURNEY ST SE
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City | OLYMPIA
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State | WA
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Zip | 98513-6779
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Country | US
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Telephone | 360-459-5312
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Fax | 360-486-9556
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | KIMBERLY HUSTON
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Credential |
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Telephone | 360-459-5312
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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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