It is completely contained within Okanogan County and the Colville Indian Reservation.

The name "Nespelem" is said to come from the Indian word nesilim, meaning "flat land".

[4] The Nespelem River originates in eastern Okanogan County and flows south.

The impounded Columbia River behind Chief Joseph Dam, into which the Nespelem River flows, is called Rufus Woods Lake.

This article related to a river in the state of Washington is a stub.