Organization
COWLITZ FAMILY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES COFFEE (CEO)
(360) 636-3892
Entity
Organization
Contact information
Practice address
1057 12TH AVE, LONGVIEW, WA 98632-2509
(360) 636-3892
(360) 414-1114
Mailing address
1057 12TH AVE, LONGVIEW, WA 98632-2509
(360) 636-3892
(360) 414-1114
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
WA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7086523
PC
WA
Enumeration date
07/18/2007
Last updated
05/31/2022
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