NPIMap

Organization Active NPI

Nisqually Indian Tribe

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Olympia, WA
National Provider Identifier
1952623027
Registry record updated Jun 17, 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
NISQUALLY INDIAN TRIBE
Doing business as
Nisqually Tribal Pharmacy
Practice address
4840 Journey St SE
Olympia, WA 98513-6779
Phone
(360) 491-9770
Fax
(360) 486-9556
NPI assigned
Feb 17, 2010
Organization subpart
No

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
Kimberly Huston
Title
Director of Operations
Phone
(360) 459-5312

Specialties & licenses 1

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

Addresses

Primary practice location

4840 Journey St SE
Olympia, WA 98513-6779

Mailing address

4840 Journey St SE
Olympia, WA 98513-6779
Phone (360) 459-5312

Other identifiers 2

IdentifierTypeStateIssuer
4933645OtherNCPDP PROVIDER IDENTIFICATION NUMBER
7054312MedicaidWA

Other names 1

  • Nisqually Tribal Pharmacy Doing business as

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.

Locations

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

4840 Journey St SE
Olympia, WA 98513
Phone (360) 456-1557

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750118400000",
    "number": "1952623027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 JOURNEY ST SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985136779",
            "telephone_number": "360-459-5312",
            "fax_number": "360-486-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 JOURNEY ST SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985136779",
            "telephone_number": "360-491-9770",
            "fax_number": "360-486-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NISQUALLY INDIAN TRIBE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-17",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A",
        "authorized_official_last_name": "HUSTON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "360-459-5312"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4933645",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7054312",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nisqually Tribal Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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.