1. Home
  2. Directory
  3. Washington
  4. Wellpinit
  5. Indian Health Service Tribal Urban Indian Health I T U Pharmacy
  6. NPI Profile

DAVID C WYNECOOP MEMORIAL CLINIC
NPI 1003963000
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy in Wellpinit, WA

Active since January 04, 2007CLIA 50D0669238 · Waiver
6203 AGENCY LOOP ROAD, WELLPINIT, WA 99040(509) 258-4517(509) 258-7152 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About David C Wynecoop Memorial Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAVID C WYNECOOP MEMORIAL CLINIC (NPI 1003963000) is a healthcare organization registered as an indian health service/tribal/urban indian health (i/t/u) pharmacy in Wellpinit, Washington and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through January 1, 2027 and lists William N Wiles, Administrative Officer, as its authorized official.

NPPES Registry Identity

NPI1003963000
Entity TypeOrganization
Primary Taxonomy332800000X
Legal Business NameDAVID C WYNECOOP MEMORIAL CLINIC
Location Address6203 AGENCY LOOP ROADWellpinit, WA 99040-0357
Mailing Address6203 Agency Loop RoadWellpinit, WA 99040-0357 · (509) 258-4517 · Fax (509) 258-7152
Phone(509) 258-4517
Fax(509) 258-7152
Organization SubpartNo
Authorized OfficialWilliam N WilesAdministrative Officer · (509) 258-4517
Enumeration DateJanuary 4, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1003963000 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIndian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacySuppliers
Taxonomy Code332800000X
Definition
An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603.
6203 AGENCY LOOP ROAD, Wellpinit, WA 99040
Open in Google Maps ↗

Other Identifiers 3

OtherPH00052198WA · License
Other4926309WA · Ncpdp Number
OtherPH00044329WA · License

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D0669238

David C Wynecoop Memorial Clinic · Wellpinit, WA
Active · expires Jan 1, 2027
CLIA Number50D0669238
Laboratory TypeTribal
Certificate Effective DateJanuary 2, 2025
Certificate Expiration DateJanuary 1, 2027
Laboratory DirectorDr. Danial Hocson
Laboratory Phone(509) 258-4517
Laboratory LocationDavid C Wynecoop Memorial Clinic6203 Agency Loop Rd, Wellpinit, WA 99040
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MARGARET JULIE KOEPPING RN-BC, MN, F.N.P.
Nurse Practitioner (Family)
6203 AGENCY LOOP ROAD
WELLPINIT, WA 99040
Stevens County (509) 258-4517
MRS. ALMA REGINA MACCLAIN RN
Registered Nurse (Ambulatory Care)
6203 AGENCY LOOP ROAD
WELLPINIT, WA 99040
Stevens County (509) 258-4517
TRACY LEE HESLER FNP
Nurse Practitioner (Family)
6203 AGENCY LOOP ROAD
WELLPINIT, WA 99040
Stevens County (509) 258-4517
DR. JAMES CHARLES JORDAN PHARMD
Pharmacist
6203 AGENCY LOOP ROAD
WELLPINIT, WA 99040
Stevens County (509) 258-4517
SPOKANE TRIBE OF INDIANS
Clinic/Center (Federally Qualified Health Center (FQHC))
6203 AGENCY LOOP ROAD
WELLPINIT, WA 99040
Stevens County (509) 258-4517
DAVID C WYNECOOP MEMORIAL HEALTH CENTER PHARMACY
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
6203 AGENCY LOOP ROAD
WELLPINIT, WA 99040
Stevens County (509) 258-4517

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is David C Wynecoop Memorial Clinic's NPI number?

The NPI number for David C Wynecoop Memorial Clinic is 1003963000. It was assigned to this organization in the NPPES registry on January 4, 2007.

Where is David C Wynecoop Memorial Clinic located?

David C Wynecoop Memorial Clinic is located at 6203 Agency Loop Road, Wellpinit, WA 99040. The listed phone number is (509) 258-4517.

What is David C Wynecoop Memorial Clinic's specialty?

The primary specialty registered for this NPI is Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy with taxonomy code 332800000X.

Does David C Wynecoop Memorial Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D0669238) is associated with this NPI, valid through January 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for David C Wynecoop Memorial Clinic was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.