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Organization
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Active
Organization
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Active
Other names
COLVILLE INDIAN HEALTH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
YVONNE L MISIASZEK (CHIEF EXECUTIVE OFFICER)
(509) 634-2900
Entity
Organization
Contact information
Practice address
29 NESPELEM SAN POIL STREET, NESPELEM, WA 99155-0071
(509) 634-2900
(509) 634-2990
Mailing address
29 NESPELEM SAN POIL STREET, NESPELEM, WA 99155-0071
(509) 634-2900
(509) 634-2990
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6021141
—
WA
Enumeration date
03/19/2007
Last updated
08/22/2020
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