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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