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Organization

NISQUALLY TRIBE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. RENA WELLS (HEALTH DIRECTOR)
(360) 459-5312
Entity
Organization

Contact information

Practice address
4816 SHE NAH NUM DR SE, OLYMPIA, WA 98513-9105
(360) 459-5312
(360) 407-0860
Mailing address
4816 SHE NAH NUM DR SE, OLYMPIA, WA 98513-9105
(360) 459-5312
(360) 407-0860

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1980887
WA
Enumeration date
08/17/2007
Last updated
08/17/2007
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