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Organization
COWLITZ INDIAN TRIBE
Active
Organization
COWLITZ INDIAN TRIBE
Active
Parent organization
COWLITZ INDIAN TRIBE
Other names
Cowlitz Indian Tribal Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
COWLITZ INDIAN TRIBE
Authorized official
SHAVON KELLER (BILLING SUPERVISOR)
(360) 353-9431
Entity
Organization
Contact information
Practice address
900 FIR ST, LONGVIEW, WA 98632-2544
(360) 353-9422
Mailing address
PO BOX 2429, LONGVIEW, WA 98632-8486
(360) 575-8275
(360) 575-1950
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
NULL
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NULL
Other
Enumeration date
04/19/2007
Last updated
10/31/2024
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