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Organization
NISQUALLY INDIAN TRIBE
Active
Organization
NISQUALLY INDIAN TRIBE
Active
Other names
Nisqually Tribal Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY HUSTON (DIRECTOR OF OPERATIONS)
(360) 459-5312
Entity
Organization
Contact information
Practice address
4840 JOURNEY ST SE, OLYMPIA, WA 98513-6779
(360) 491-9770
(360) 486-9556
Mailing address
4840 JOURNEY ST SE, OLYMPIA, WA 98513-6779
(360) 459-5312
(360) 486-9556
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
01
—
4933645
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
7054312
—
WA
Enumeration date
02/17/2010
Last updated
06/17/2025
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