COWLITZ INDIAN TRIBE


Address: 15455 65th Ave S, Tukwila, WA 98188
Phone: 2067215170

COWLITZ INDIAN TRIBE (NPI# 1538412630) 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) 1538412630
Entity Type Organization
Organization Name COWLITZ INDIAN TRIBE
Other Organization Name COWLITZ TRIBAL TREATMENT
Practice Address 15455 65th Ave S
Tukwila
WA 98188
Mailing Address Po Box 2429
Longview
WA 98632-8486
Practice Telephone 2067215170
Practice Fax Number 2067216288
Mailing Telephone 2067215170
Mailing Fax Number 2067216288
Enumeration Date 2012-10-26
Last Update Date 2018-08-22
Authorized Official Name SHAVON KELLER (BILLING SUPERVISOR)
Authorized Official Telephone 3603539431
Is Organization Subpart Y
Parent Organization Name COWLITZ INDIAN TRIBE

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QH0100X Clinic/Center
Specialization: Health Service
Ambulatory Health Care Facilities
Y 261QR0405X Clinic/Center
Specialization: Rehabilitation, Substance Use Disorder
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Cowlitz Tribal Treatment Other Name - Individual/Organization

Provider Secondary Practice Location

Address Telephone Number Fax Number
6450 Southcenter Blvd, Tukwila, WA 981882552 2067215170 3603539440

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
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
1346465101 Cowlitz Indian Tribe Clinic/Center 1044 11th Ave, Longview, WA 98632-2506 2007-04-16
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 15455 65TH AVE S
City TUKWILA
State WA
Zip Code 98188

Providers in the same location

NPI Name Taxonomy Address Enumeration
1912078361 Eduardo Abuyog Social Worker 15455 65th Ave S, Tukwila, WA 98188-2534 2006-11-09
1720637424 Tara Lynn Taylor Registered Nurse 15455 65th Ave S, Tukwila, WA 98188-2534 2019-09-05
1326509597 Gabrielle Gutierrez Registered Nurse 15455 65th Ave S, Tukwila, WA 98188-2534 2019-03-28
1083184097 Fredy E Cortez Counselor 15455 65th Ave S, Tukwila, WA 98188-2534 2018-12-03
1689142903 Ingrid Buchan Counselor 15455 65th Ave S, Tukwila, WA 98188-2534 2018-11-05
1407323942 Michele Marie Perrin Counselor 15455 65th Ave S, Tukwila, WA 98188-2534 2018-11-01
1194205609 Stephanie Marie Degroat Social Worker 15455 65th Ave S, Tukwila, WA 98188 2018-08-15
1689150997 Tate J Bates Social Worker 15455 65th Ave S, Tukwila, WA 98188 2018-07-19
1235624487 Robert Jay Ramirez Social Worker 15455 65th Ave S, Tukwila, WA 98188-2534 2018-06-28
1629561634 Sandra S Baker Social Worker 15455 65th Ave S, Tukwila, WA 98188-2534 2018-06-13
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1194342774 Yemisirach Fikru Tufa Registered Nurse 3039 S 154th St, Aptb304, Seatac, WA 98188 2020-06-30
1841756608 Silvia Ruby Campos Behavior Technician 651 Stander Blvd., Suite 112, Tukwila, WA 98188 2019-02-18
1720562036 Alissa Hayes Counselor 631 Strander Bvd. Ste A., Tukwila, WA 98188 2018-09-21
1457859035 Bashayer S Albadr Student in an Organized Health Care Education/Training Program 6100 South Center Blvd. 3rd Floor, Tukwila, WA 98188 2018-01-29
1356855522 Miguel Angel Banos Massage Therapist 3000 Ne 4th St., Renton, WA 98188 2017-11-27
1801312061 Emma Sinclair Jennings Counselor 651 Strander Blvd. Suite 105, Tukwila, WA 98188 2017-08-19
1518417526 Jamila Fyrouz Iraqui Counselor 15142 65th Ave S, Apt. 312, Tukwila, WASHINGTON 98188 2016-10-13
1487026076 Catholic Community Services of Western Washington Clinic/Center 631 Strander Blvd Ste A, Tukwila, WA 98188 2015-10-22
1659773174 Thanh Thi-hong Nguyen Physician Assistant 3739 S 191st Pl, Seatac, WA 98188 2014-09-16
1053725101 Affinity Home Care Services Inc In Home Supportive Care 601 Strander Blvd, Tukwila, WA 98188 2014-06-17
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Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

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1386278372 Social Treatment Opportunity Programs II, Inc Clinic/Center 600 S 1st Ave, Othello, WA 99344-1703 2020-02-27
1326672692 Excelsior Integrated Care Center LLC Clinic/Center 3910 W. Indian Trail Rd, Spokane, WA 99208-4739 2020-02-26
1659919561 Baart Behavioral Health Services, Inc. Clinic/Center 716 S Chase St, Port Angeles, WA 98362-6122 2019-12-11
1346888260 Baart Behavioral Health Services, Inc. Clinic/Center 1520 Ne Riddell Rd Ste 110, Bremerton, WA 98310-3005 2019-12-11
1437634730 Hazelden Betty Ford Foundation Clinic/Center 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 2018-10-02
1780174441 American Behavioral Health Systems, Inc. Clinic/Center 715 E Sprague Ave Ste 107, Spokane, WA 99202-2142 2018-05-17
1598255267 American Behavioral Healt Systems, Inc. Clinic/Center 7208 267th St Nw Ste A-100, Stanwood, WA 98292-6289 2018-05-17
1437648136 American Behavioral Health Systems, Inc. Clinic/Center 8625 Evergreen Way Ste 100, Everett, WA 98208-2620 2018-05-08
1487143350 Steve Parker Clinic/Center 1206 State Ave Ste H, Marysville, WA 98270-3645 2018-05-07
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Competitor

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City TUKWILA
Zip Code 98188

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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