# NOOKSACK INDIAN TRIBE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NOOKSACK INDIAN TRIBE
- **Other names:** Nooksack Dental Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1699967265
- **Legal business name:** NOOKSACK INDIAN TRIBE
- **Authorized official:** MR. RICHARD GEORGE (DIRECTOR OF HEALTH & SOCIAL SERVICE)
- **Authorized official phone:** (360) 592-5176

## Contact information

- **Practice address:** 6760 MISSION RD, EVERSON, WA 98247-9749
- **Practice address phone:** (360) 306-5151
- **Mailing address:** PO BOX 157, DEMING, WA 98244-0157
- **Mailing address phone:** (360) 592-5176

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | WA | Yes |

## Other

- **Enumeration date:** 08/16/2007
- **Last updated:** 07/21/2022