Organization
COQUILLE INDIAN TRIBE
Active
Other names
Ko-Kwel Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHARISE RICH (BILLING MANAGER)
(541) 888-9494
Entity
Organization
Contact information
Practice address
630 MILUK DR, COOS BAY, OR 97420-7728
(541) 888-9494
(541) 888-4435
Mailing address
PO BOX 3190, COOS BAY, OR 97420-0407
(541) 888-9494
(541) 888-4435
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165031
—
OR
01
—
261Q00000X
TAXONOMY
OR
Enumeration date
05/08/2006
Last updated
11/03/2025
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