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FQHC638478 NOOKSACK INDIAN TRIBE OF WASHINGTON (Active)
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Main Details
Name
NOOKSACK INDIAN TRIBE OF WASHINGTON
Subdivision Name
NOOKSACK COMMUNITY HEALTH CLINIC
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638478
Additional Details
Current Program Status
Active
Registration Date
7/1/2002
Participating Start Date
7/1/2002
Participating Approval Date
12/23/2003
Last Recertification Date
2/18/2025
Contacts
Authorizing Official
Nooksack Indian Tribe
Lona Johnson, Health Director
(360) 966-2106
Primary Contact
Nooksack Health Clinic
Andrea Garcia, Clinic Manager
(360) 966-2106
Addresses
Street Address
2510 Sulwhanon Drive
EVERSON, WA 98247
Billing Address
Nooksack Indian Tribe
PO Box 157
Deming, WA 98244
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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Termination error, terminated and reinstated same day JH 5/7/12
05/07/2012
ADDED CP ARRANGEMENT
12/23/2003
April 2025
April 2025
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