NPIMap

Organization Active NPI

Nisqually Tribe

  • Clinic/Center
  • Olympia, WA
National Provider Identifier
1003008558
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NISQUALLY TRIBE
Practice address
4816 She Nah Num Dr SE
Olympia, WA 98513-9105
Phone
(360) 459-5312
Fax
(360) 407-0860
NPI assigned
Aug 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Rena Wells
Title
Health Director
Phone
(360) 459-5312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X WA Primary

Addresses

Primary practice location

4816 She Nah Num Dr SE
Olympia, WA 98513-9105

Mailing address

4816 She Nah Num Dr SE
Olympia, WA 98513-9105
Phone (360) 459-5312

Other identifiers 1

IdentifierTypeStateIssuer
5400080MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Nisqually Indian Tribe8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73054

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1003008558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4816 SHE NAH NUM DR SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985139105",
            "telephone_number": "360-459-5312",
            "fax_number": "360-407-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4816 SHE NAH NUM DR SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985139105",
            "telephone_number": "360-459-5312",
            "fax_number": "360-407-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NISQUALLY TRIBE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-17",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "RENA",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "360-459-5312",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5400080",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.