Organization
COWLITZ FAMILY HEALTH CENTER
Active
Parent organization
COWLITZ FAMILY HEALTH CENTER
Other names
Family Health Center Castle Rock Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
COWLITZ FAMILY HEALTH CENTER
Authorized official
JAMES K COFFEE (CEO)
(360) 636-3892
Entity
Organization
Contact information
Practice address
139 1ST AVE SW, CASTLE ROCK, WA 98611
(360) 274-2353
(360) 274-7439
Mailing address
1057 12TH AVE, LONGVIEW, WA 98632-2509
(360) 636-3892
(360) 232-8400
Taxonomy
Speciality
Code
Description
License number
State
261QF0050X
Non-Surgical Family Planning Clinic/Center
600176084
WA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
600176084
WA
261QM0850X
Adult Mental Health Clinic/Center
600176084
WA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
600176084
WA
261QP2300X
Primary Care Clinic/Center
600176084
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437359551
—
WA
05
—
7086523
—
WA
05
—
7900426
—
WA
Enumeration date
09/25/2015
Last updated
05/31/2022
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