Cowlitz Indian Tribe
NPI #1619194123 in Longview, Washington
Provider Information
- NPI Number
- 1619194123
- Entity Type
- Organization
- Organization Name
- Cowlitz Indian Tribe
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- COWLITZ INDIAN TRIBE
- Primary Specialty
- Preventive Medicine - Public Health & General Preventive Medicine
- Enumeration Date
- Apr 19, 2007
- Last Updated
- Oct 31, 2024
Practice Location
- Address
- 900 FIR ST
- City
- Longview
- State
- Washington
- ZIP Code
- 98632-2544
- Phone
- (360) 353-9422
Authorized Official
- Name
- SHAVON KELLER
- Title
- BILLING SUPERVISOR
- Phone
- (360) 353-9431
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Health Service — Health Service |
| Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center) |
| Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder |
| Preventive Medicine - Public Health & General Preventive Medicine — Public Health & General Preventive Medicine |
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