Organization
CONFEDERATED TRIBES OF COOS, LOWER UMPQUA & SIUSLAW INDIANS
Active
Other names
Three Rivers Health Center - Coos Bay, Confederated Tribes of Coos, Lower Umpqua & Siuslaw Indians
Organization subpart
No
Provider details
NPI number
Authorized official
DAVON LORENZO SMITH (CHIEF OPERATIONS OFFICER)
(541) 294-0595
Entity
Organization
Contact information
Practice address
150 S WALL ST, COOS BAY, OR 97420-3233
(541) 435-7200
(541) 888-0025
Mailing address
150 S WALL ST, COOS BAY, OR 97420-3233
(541) 435-7200
(541) 888-0025
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165383
—
OR
05
—
500838955
—
OR
01
—
RP-0003971
OREGON BOARD OF PHARMACY - RETAIL DRUG OUTLET
OR
01
—
RP-0003971-CS
OREGON BOARD OF PHARMACY - CONTROLLED SUBSTANCE
OR
Enumeration date
11/13/2006
Last updated
04/13/2026
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