Organization
COWLITZ FAMILY HEALTH CENTER
Active
Parent organization
FAMILY HEALTH CENTER
Other names
Family Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAMILY HEALTH CENTER
Authorized official
JAMES COFFEE (CEO)
(360) 636-3892
Entity
Organization
Contact information
Practice address
335 UNA AVE, CATHLAMET, WA 98612-9583
(360) 465-2990
(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
261Q00000X
Clinic/Center
600176084
WA
261QF0050X
Non-Surgical Family Planning Clinic/Center
600176084
WA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
600176084
WA
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50-1922
MEDICARE PTAN
WA
05
—
7086523
—
WA
05
—
7407349
—
WA
05
—
7900426
—
WA
Enumeration date
12/03/2009
Last updated
05/24/2024
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