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Organization

COWLITZ INDIAN TRIBE

Active
Parent organization
NORTHSTAR CLINIC
Other names
Cowlitz Indian Tribe, NorthStar Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
NORTHSTAR CLINIC
Authorized official
SHAVON KELLER (BILLING SUPERVISOR)
(360) 353-9431
Entity
Organization

Contact information

Practice address
7105 NE 40TH ST, VANCOUVER, WA 98661-3058
(360) 353-9431
(360) 353-9440
Mailing address
PO BOX 2429, LONGVIEW, WA 98632-8486
(206) 721-5170
(206) 721-6288

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM2800X
Methadone Clinic
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary

Other

Enumeration date
10/26/2012
Last updated
10/02/2025
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