NPIMap

Organization Active NPI

Nisqually Indian Tribe

  • Public Health or Welfare Agency
  • Olympia, WA
National Provider Identifier
1730075581
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
NISQUALLY INDIAN TRIBE
Practice address
11702 Yelm Hwy SE
Olympia, WA 98513-9109
Phone
(360) 459-9603
NPI assigned
Jun 17, 2025
Last updated
Jun 17, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
NISQUALLY INDIAN TRIBEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Authorized official

Name
Jeff Smith
Title
Lieutenant
Phone
(360) 459-9603

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary
Health Service Clinic/Center 261QH0100X NU

Addresses

Primary practice location

11702 Yelm Hwy SE
Olympia, WA 98513-9109

Mailing address

4820 She Nah Num Dr SE
Olympia, WA 98513-9105
Phone (360) 459-9603

Other names 1

  • Nisqually Corrections Other name

National Provider Directory

National Provider Directory
Tax ID family
Nisqually Tribal Clinic8 organizations share this tax ID, including this one
Part of
Nisqually Tribal Clinic

Other organizations with this tax ID 7

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

Locations

11702 Yelm Hwy SE
Olympia, WA 98513
Phone (360) 413-3039

Practitioners & affiliated clinicians

Practitioners 6

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": "1750118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750118400000",
    "number": "1730075581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 SHE NAH NUM DR SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985139105",
            "telephone_number": "360-459-9603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11702 YELM HWY SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985139109",
            "telephone_number": "360-459-9603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NISQUALLY INDIAN TRIBE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NISQUALLY INDIAN TRIBE",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "LIEUTENANT",
        "authorized_official_telephone_number": "360-459-9603"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nisqually Corrections",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jun 17, 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.