COLVILLE CONFEDERATED TRIBES NPI 1174625446

Clinic/Center (Mental Health (Including Community Mental Health Center)) in Nespelem, WA

NPI 1174625446 Organization Clinic/Center Mental Health (Including Community Menta...

About COLVILLE CONFEDERATED TRIBES

Colville Confederated Tribes is a provider established in Nespelem, Washington specializing in clinic/center (mental health (including community mental health center)) . The NPI number of Colville Confederated Tribes is 1174625446 and was assigned on September 2006. The practitioner's primary taxonomy code is 261QM0801X. The provider is registered as an organization and their NPI record was last updated 15 years ago. The authorized official of this NPI record is Martha Holliday (Health And Human Service Director)

NPI

1174625446

Provider NameCOLVILLE CONFEDERATED TRIBES
Provider Location Address1 COLVILLE STREET NESPELEM, WA 99155
Provider Mailing Address1 COLVILLE STREET NESPELEM, WA 99155
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date09-05-2006
Last Update Date07-17-2007


Primary Taxonomy

Taxonomy Code261QM0801X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationMental Health (Including Community Mental Health Center)

Business Address

COLVILLE CONFEDERATED TRIBES
1 COLVILLE STREET
NESPELEM, WA
ZIP 99155
Phone: (509) 634-2433
Fax: (509) 634-2781

Get Directions


Mailing Address

COLVILLE CONFEDERATED TRIBES
1 COLVILLE STREET
NESPELEM, WA
ZIP 99155
Phone: (509) 634-2433
Fax: (509) 634-2781



Authorized Official

Authorized Official Name MARTHA HOLLIDAY
Authorized Official TitleHEALTH AND HUMAN SERVICE DIRECTOR
Authorized Official Phone(509) 634-2433

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
8027476MEDICAID (05)WA

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1225256530 BERNADINE VILLEGAS CDP
Individual
Counselor (Addiction (Substance Use Disorder))1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1295953669 DEE A GUNSHOWS RC
Individual
Counselor (Addiction (Substance Use Disorder))1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1558589937 LAWRENCE J FRY SR. CDP
Individual
Counselor (Addiction (Substance Use Disorder))1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1356569677 LAURAE A MACCLAIN RC
Individual
Counselor (Mental Health)1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1396963864 RAMONA C CAMPOBASSO RC
Individual
Counselor (Mental Health)1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1568680031 JAMES G PERKINS RC
Individual
Counselor (Mental Health)1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1225256795 RICHARD A MANNING RC
Individual
Speech-Language Pathologist1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1396963625 MARCELLA R PALMER LW
Individual
Counselor (Mental Health)1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1659599033 PHYLLIS J ERICKSON RC
Individual
Social Worker (Clinical)1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1619184041 RONALD JAMES WHITNEY EMT
Individual
Emergency Medical Technician, Basic1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1427265024MR. WILLIAM ARCHIE DENNIS EMT-B
Individual
Emergency Medical Technician, Basic1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1336356732MRS. KRISTIN JEANINE KOEPKE EMT-B
Individual
Emergency Medical Technician, Basic1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1184831745MRS. JOSEPHINE E MARCELLEY LICSW
Individual
Counselor (Mental Health)1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1205043718MR. JESSE PAUL SCHUMACHER EMS-B
Individual
Emergency Medical Technician, Basic1 COLVILLE STREET
NESPELEM, WA 99155
(509) 637-2727
1306053715MRS. STEPHANIE ALICE SCHUMACHER EMT-B
Individual
Emergency Medical Technician, Basic1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1265649552 RONALD LAWRENCE SHAFFER EMT-B
Individual
Emergency Medical Technician, Basic1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1750598041 SERENNA KATHLEEN TAYLOR EMT-B
Individual
Emergency Medical Technician, Basic1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1063629350MRS. LORINDA ANN GOODMAN EMT-B
Individual
Emergency Medical Technician, Basic1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1851508147MS. DONITA A SWAN EMT-B
Individual
Emergency Medical Technician, Basic1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727
1003023300MS. JOLEEN ANNE MOLLENBERG EMT-B
Individual
Emergency Medical Technician, Basic1 COLVILLE STREET
NESPELEM, WA 99155
(509) 634-2727

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.