COWLITZ INDIAN TRIBE


Address: 1044 11th Ave, Longview, WA 98632-2506
Phone: 3605758275

COWLITZ INDIAN TRIBE (NPI# 1346465101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1346465101
Entity Type Organization
Organization Name COWLITZ INDIAN TRIBE
Other Organization Name COWLITZ INDIAN TRIBAL HEALTH SERVICES
Practice Address 1044 11th Ave
Longview
WA 98632-2506
Mailing Address Po Box 2429
Longview
WA 98632-8486
Practice Telephone 3605758275
Practice Fax Number 3605751950
Mailing Telephone 3605758275
Mailing Fax Number 3605751950
Enumeration Date 2007-04-16
Last Update Date 2018-03-22
Authorized Official Name SHAVON KELLER (BILLING SUPERVISOR)
Authorized Official Telephone 3603539431
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QH0100X Clinic/Center
Specialization: Health Service
Ambulatory Health Care Facilities
Y 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
WA 7122898 05

Other Provider/Organization Names

Other Name Type Code
Cowlitz Indian Tribal Health Services Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1861722258 Cowlitz Indian Tribe Clinic/Center 107 Spencer Rd, Toledo, WA 98591 2010-01-06
1164649679 Cowlitz Indian Tribe Clinic/Center 7700 Ne 26th Ave, Vancouver, WA 98665-0672 2007-04-19
1972962165 Cowlitz Indian Tribe Clinic/Center 7700 Ne 26th Ave, Vancouver, WA 98665-0672 2016-02-16
1225382328 Cowlitz Indian Tribe Clinic/Center 15455 65th Ave S, Tukwila, WA 98188 2012-10-29
1538412630 Cowlitz Indian Tribe Clinic/Center 15455 65th Ave S, Tukwila, WA 98188 2012-10-26
1740562909 Cowlitz Indian Tribe Clinic/Center 1044 11th Ave, Longview, WA 98632-2506 2011-09-14
1619194123 Cowlitz Indian Tribe Clinic/Center 922 Fir St, Longview, WA 98632 2007-04-19
1528285038 Cowlitz Indian Tribe Clinic/Center 900 Fir St, Longview, WA 98632 2007-04-19
1851328447 Cowlitz Indian Tribe Clinic/Center 1044 11th Ave, Longview, WA 98632 2006-06-27

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities COWLITZ INDIAN TRIBE 1055 9th Ave Ste B, Longview, WA 98632-2661

Office Location

Street Address 1044 11TH AVE
City LONGVIEW
State WA
Zip Code 98632-2506

Providers in the same location

NPI Name Taxonomy Address Enumeration
1851347454 Joyce Elaine Tobias Nurse Practitioner 1044 11th Ave, Suite A, Longview, WA 98632-2506 2006-05-25
1205454717 Randi Lyn Powell Sexton Registered Nurse 1044 11th Ave, Longview, WA 98632-2506 2020-07-10
1821636143 Bridie Jo Ann Rogers Registered Nurse 1044 11th Ave, Longview, WA 98632-2506 2019-12-17
1225596836 Thomas Joseph Burckhardt Jr. Registered Nurse 1044 11th Ave, Longview, WA 98632-2506 2019-03-04
1689138729 Alyssa Chana Fine Registered Nurse 1044 11th Ave, Longview, WA 98632-2506 2019-01-23
1285133876 Angela Lynn Dunn Counselor 1044 11th Ave, Longview, WA 98632-2506 2018-02-08
1710497839 Christopher Leslie Standridge Counselor 1044 11th Ave, Longview, WA 98632-2506 2017-10-03
1790215499 Allison Taylor Counselor 1044 11th Ave, Longview, WA 98632-2506 2017-06-14
1952840944 Kelsey Delagrange Counselor 1044 11th Ave, Longview, WA 98632-2506 2017-02-23
1679025019 Leslie Pfannes Counselor 1044 11th Ave, Longview, WA 98632-2506 2016-11-02
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1851992366 Honor Senior Care LLC Home Health Aide 1135 3rd Ave, Ste S101, Longview, WA 98632 2020-11-03
1417416728 Sam Wise Dentist 1538 11th Ave Lowr Columbia, Longview, WA 98632 2019-03-16
1053870717 Matthew Johnson Physician Assistant 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 2019-03-12
1295205367 Abid Valji Occupational Therapist Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 2018-11-30
1184106437 Peacehealth Durable Medical Equipment & Medical Supplies Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 2018-09-04
1982186318 Linda Joan Mason Licensed Practical Nurse 1153 23rd Ave, Longview, WA 98632 2018-09-01
1891291910 Ellen Sumner Hornbeak Physical Therapist 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 2018-04-05
1700399961 Johnna Joyce Knapp Speech-Language Pathologist 2615 Lilac St, Longview, WA 98632 2017-11-09
1841711868 Deborah Annette Burzynski Registered Nurse 1057 12th Avenue, Longview, WA 98632 2017-06-29
1598291122 Cheyenne West Counselor 1616 10th Avenue, Longview, WA 98632 2017-05-02
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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1609382209 Beverly Advanced Practice Nursing, Pllc Clinic/Center 103a Woodbine Pl, Longview, TX 75601-2912 2017-12-18
1386003036 Evelyn L Green Clinic/Center 818 N 4th St, Longview, TX 75601-5433 2016-02-22
1447540240 Careplus of East Texas Pllc Clinic/Center 2010 Bill Owens Pkwy, Location 2: 1600 E. Broadway, Gladewater, Tx 75647, Longview, TX 75604-6210 2011-04-13
1457472110 Sita M Devulapalli, Md, Pa Clinic/Center 903 Walnut Hill Dr, Suite 1, Longview, TX 75605-5062 2007-04-02

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1063056497 A Community Wellness Clinic LLC Clinic/Center 2405 E 17th Ave Ste 113, Spokane, WA 99223-5122 2019-10-29
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Competitor

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City LONGVIEW
Zip Code 98632

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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