National Provider Identifier Database

CONFEDERATED TRIBES OF THE COLVILLE RESERVATION
Clinic Pharmacy

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.


Contact Information

CONFEDERATED TRIBES OF THE COLVILLE RESERVATION
11665 WA HWY 21
KELLER, WA99140-7300
Phone: 509-634-7389
Fax:
Website:
Specialty Taxonomy Code
* Clinic Pharmacy 3336C0002X

* Indicates primary specialty

NPI Profile & details for CONFEDERATED TRIBES OF THE COLVILLE RESERVATION

NPI Number 1093679862
Legal business name
LBN
CONFEDERATED TRIBES OF THE COLVILLE RESERVATION
Authorized official AMY CHURCH - (REVENUE CYCLE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 12/15/2025
Last updated 03/25/2026 - About 2 months ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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