Cowlitz Indian Tribe
NPI #1740562909 in Longview, Washington
Provider Information
- NPI Number
- 1740562909
- Entity Type
- Organization
- Organization Name
- Cowlitz Indian Tribe
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Sep 14, 2011
- Last Updated
- Mar 22, 2018
Practice Location
- Address
- 1044 11TH AVE
- City
- Longview
- State
- Washington
- ZIP Code
- 98632-2506
- Phone
- (360) 575-8275
Authorized Official
- Name
- SHAVON KELLER
- Title
- BILLING SUPERVISOR
- Phone
- (360) 353-9431
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Health Service — Health Service |
| Clinic/Center |
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