NPIMap

Organization Active NPI

Port Gamble S'Klallam Tribe

Doing business as Port Gamble S'Klallam Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Kingston, WA
National Provider Identifier
1922970458
Registry record updated Jul 27, 2026
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
PORT GAMBLE S'KLALLAM TRIBE
Doing business as
Port Gamble S'Klallam Pharmacy
Practice address
32014 Little Boston Rd NE
Kingston, WA 98346-9734
Phone
(833) 573-4348
Fax
(360) 360-2310
NPI assigned
Sep 23, 2025
Last updated
Jul 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Authorized official

Name
Joel Wright
Title
President of Pharmacy Services
Phone
(806) 242-7782

Specialties & licenses 1

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

Addresses

Primary practice location

32014 Little Boston Rd NE
Kingston, WA 98346-9734

Mailing address

416 S Tyler St
Amarillo, TX 79101-2346
Phone (806) 242-7782

Other identifiers 1

IdentifierTypeStateIssuer
2390687MedicaidWA

Other names 1

  • Port Gamble S'Klallam Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260604000775 WA DME Supplier - Pharmacy 6204737927 Practice locations: Kingston, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Port Gamble S'Klallam Dental Clinic7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Port Gamble S'Klallam TribeKingston, WA, CCN 501839 Federally qualified health center Operational/Managerial Control Jul 1, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1758585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785110400000",
    "number": "1922970458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 S TYLER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791012346",
            "telephone_number": "806-242-7782",
            "fax_number": "360-360-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32014 LITTLE BOSTON RD NE",
            "city": "KINGSTON",
            "state": "WA",
            "postal_code": "983469734",
            "telephone_number": "833-573-4348",
            "fax_number": "360-360-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT GAMBLE S'KLALLAM TRIBE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-23",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "PRESIDENT OF PHARMACY SERVICES",
        "authorized_official_telephone_number": "806-242-7782"
    },
    "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": "2390687",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Port Gamble S'Klallam Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingston, WA

Sources for this page

Verify at the official NPI Registry.