Organization
COWLITZ FAMILY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES J COFFEE (CEO)
(360) 636-3892
Entity
Organization
Contact information
Practice address
621 GRADE ST, KELSO, WA 98626-2606
(360) 636-3892
(360) 232-8400
Mailing address
1057 12TH AVE, LONGVIEW, WA 98632-2509
(360) 636-3892
(360) 232-8400
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
03/24/2014
Last updated
05/31/2022
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