Organization
COWLITZ FAMILY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K COFFEE CEO (CEO)
(360) 636-3892
Entity
Organization
Contact information
Practice address
2232 S SILVER LAKE RD, CASTLE ROCK, WA 98611-8021
(360) 274-3262
(360) 274-3345
Mailing address
1057 12TH AVE, LONGVIEW, WA 98632-2509
(360) 636-3892
(360) 232-8400
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437359551
—
WA
05
—
1992809
—
WA
05
—
1995182
—
WA
05
—
8029365
—
WA
Enumeration date
04/10/2007
Last updated
02/27/2023
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