# COWLITZ INDIAN TRIBE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770166365
- **Authorized official:** STEVEN KUTZ (EXECUTIVE DIRECTOR HHS)
- **Authorized official phone:** (360) 575-8275

## Contact information

- **Practice address:** 1000 DAVIS PL, DUPONT, WA 98327-8781
- **Practice address phone:** (206) 721-5170
- **Practice address fax:** (206) 721-6288
- **Mailing address:** PO BOX 2429, LONGVIEW, WA 98632-8486
- **Mailing address phone:** (360) 353-9431
- **Mailing address fax:** (360) 353-9440

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | NULL | Yes |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | — | Yes |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 04/30/2021
- **Last updated:** 04/30/2021