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Contact Information

CONFEDERATED TRIBES OF THE COLVILLE RESERVATION
11665 WA HWY 21
KELLER, WA99140-7300
 Phone: 509-634-7389
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinic Pharmacy

3336C0002X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for CONFEDERATED TRIBES OF THE COLVILLE RESERVATION

NPI # 1093679862
LBN Legal business name CONFEDERATED TRIBES OF THE COLVILLE RESERVATION
Authorized official AMY CHURCH - (REVENUE CYCLE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 12/15/2025
Last updated 03/25/2026 - About 2 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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