# NOOKSACK DENTAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NOOKSACK TRIBE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1891843769
- **Legal business name:** NOOKSACK TRIBE
- **Authorized official:** MRS. ROSEMARY MORRIS CDA (DENTAL OFFICE MANAGER)
- **Authorized official phone:** (360) 306-5151

## Contact information

- **Practice address:** 6760 MISSION RD, EVERSON, WA 98247-9749
- **Practice address phone:** (360) 306-5151
- **Practice address fax:** (360) 306-5191
- **Mailing address:** 6760 MISSION RD, EVERSON, WA 98247-9749
- **Mailing address phone:** (360) 306-5151
- **Mailing address fax:** (360) 306-5191

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE00010128 | WA | Yes |

## Other

- **Enumeration date:** 01/08/2007
- **Last updated:** 08/17/2007