NPIMap

Organization Active NPI

Confederated Tribes of the Colville Reservation

  • Clinic Pharmacy
  • Keller, WA
National Provider Identifier
1093679862
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
CONFEDERATED TRIBES OF THE COLVILLE RESERVATION
Practice address
11665 Wa Hwy 21
Keller, WA 99140-7300
Phone
(509) 634-7389
NPI assigned
Dec 15, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Authorized official

Name
Amy Church
Title
Revenue Cycle Director
Phone
(509) 634-2783

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X
Clinic Pharmacy 3336C0002X Primary

Addresses

Primary practice location

11665 Wa Hwy 21
Keller, WA 99140-7300

Mailing address

PO Box 150
Nespelem, WA 99155-0150
Phone (509) 634-2783

Other names 1

  • San Poil Health Center Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Confederated Tribes of the Colville Reservation16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1765756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780531200000",
    "number": "1093679862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150",
            "city": "NESPELEM",
            "state": "WA",
            "postal_code": "991550150",
            "telephone_number": "509-634-2783",
            "fax_number": "509-634-2963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11665 WA HWY 21",
            "city": "KELLER",
            "state": "WA",
            "postal_code": "991407300",
            "telephone_number": "509-634-7389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONFEDERATED TRIBES OF THE COLVILLE RESERVATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-15",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "509-634-2783"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Poil Health Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Keller, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; 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.