NPIMap

Organization Active NPI

Omak Tribal Health Clinic

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Omak, WA
National Provider Identifier
1679607956
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
Legal business name
OMAK TRIBAL HEALTH CLINIC
Practice address
617 Benton St
Omak, WA 98841-9636
Phone
(509) 634-2900
Fax
(509) 634-2990
NPI assigned
Mar 16, 2007
Last updated
Aug 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Authorized official

Name
Yvonne Iverson
Title
Acting Ceo
Phone
(509) 634-2900

Specialties & licenses 1

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

Addresses

Primary practice location

617 Benton St
Omak, WA 98841-9636

Mailing address

617 Benton St
Omak, WA 98841-9636
Phone (509) 634-2900

Other identifiers 1

IdentifierTypeStateIssuer
6026850MedicaidWA

Other names 1

  • DHHS IHS COLVILLE SERVICE UNIT Other name

National Provider Directory

National Provider Directory
Tax ID family
DHHS IHS Colville Service Unit2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756080000000",
    "number": "1679607956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 BENTON ST",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419636",
            "telephone_number": "509-634-2900",
            "fax_number": "509-634-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 BENTON ST",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419636",
            "telephone_number": "509-634-2900",
            "fax_number": "509-634-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMAK TRIBAL HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A",
        "authorized_official_last_name": "IVERSON",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_title_or_position": "ACTING CEO",
        "authorized_official_telephone_number": "509-634-2900"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6026850",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DHHS IHS COLVILLE SERVICE UNIT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Omak, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.