Organization
COWLITZ FAMILY HEALTH CENTER
Active
Parent organization
COWLITZ FAMILY HEALTH CENTER
Other names
Family Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
COWLITZ FAMILY HEALTH CENTER
Authorized official
JAMES K COFFEE MPA (CEO)
(360) 353-5803
Entity
Organization
Contact information
Practice address
831 12TH AVE, LONGVIEW, WA 98632-2403
(360) 998-2357
(360) 998-2887
Mailing address
1057 12TH AVE, LONGVIEW, WA 98632-2509
(360) 261-7848
(360) 232-8400
Taxonomy
Speciality
Code
Description
License number
State
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437359551
—
WA
Enumeration date
03/14/2022
Last updated
10/18/2022
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