Organization
COWLITZ FAMILY HEALTH CENTER
Active
Parent organization
COWLITZ FAMILY HEALTH CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
COWLITZ FAMILY HEALTH CENTER
Authorized official
JAMES COFFEE (CEO)
(360) 636-3892
Entity
Organization
Contact information
Practice address
1251 LEWIS RIVER RD STE D, WOODLAND, WA 98674-9203
(360) 225-4310
(360) 225-4339
Mailing address
1057 12TH AVE, LONGVIEW, WA 98632-2509
(360) 636-3892
(360) 414-1114
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
WA
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
WA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
WA
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7086523
—
WA
05
—
7407349
—
WA
05
—
7900426
—
WA
Enumeration date
12/13/2006
Last updated
05/24/2024
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