Organization
COW CREEK BAND OF UMPQUA TRIBE OF INDIANS
Active
Other names
Cow Creek Health & Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON A STANPHILL (CHIEF HEALTH OFFICER)
(541) 672-8533
Entity
Organization
Contact information
Practice address
480 WARTAHOO LN, CANYONVILLE, OR 97417-9683
(541) 839-1345
(855) 670-1791
Mailing address
2371 NE STEPHENS ST, SUITE 200, ROSEBURG, OR 97470-1372
(541) 672-8533
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500745176
—
OR
Enumeration date
06/13/2013
Last updated
08/05/2021
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