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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