COWLITZ INDIAN TRIBE


Address: 922 Fir St, Longview, WA 98632
Phone: 3605758275

COWLITZ INDIAN TRIBE (NPI# 1619194123) 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) 1619194123
Entity Type Organization
Organization Name COWLITZ INDIAN TRIBE
Other Organization Name COWLITZ INDIAN TRIBAL HEALTH SERVICES
Practice Address 922 Fir St
Longview
WA 98632
Mailing Address Po Box 2429
Longview
WA 98632-8486
Practice Telephone 3605758275
Mailing Telephone 3605758275
Mailing Fax Number 3605751950
Enumeration Date 2007-04-19
Last Update Date 2018-07-16
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 2083P0901X Preventive Medicine
Specialization: Public Health & General Preventive Medicine
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
WA 1981224 05

Other Provider/Organization Names

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

Provider Secondary Practice Location

Address Telephone Number Fax Number
1044 11th Ave, Suite A, Longview, WA 986322506 3605758275 3605751950

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
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 922 FIR ST
City LONGVIEW
State WA
Zip Code 98632

Providers in the same location

NPI Name Taxonomy Address Enumeration
1306832274 Tina M Taylor Registered Nurse 922 Fir St, Longview, WA 98632-2525 2005-09-26
1558804997 Maegan R Skorepa Counselor 922 Fir St, Longview, WA 98632-2525 2016-12-01
1740653989 Korrie Kashuba Counselor 922 Fir St, Longview, WA 98632-2525 2015-11-10
1568703932 Virginia Peyton Hemming Counselor 922 Fir St, Longview, WA 98632 2013-03-11
1144392325 Aniezka M Jenissen Counselor 922 Fir St, Longview, WA 98632-2525 2006-11-14

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 2083P0901X
Grouping Allopathic & Osteopathic Physicians
Classification Preventive Medicine
Specialization Public Health & General Preventive Medicine

Taxonomy Definition

Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1851840508 Kimquy Kieu Preventive Medicine 711 24th Ave S, Seattle, WA 98144-3003 2016-09-22
1659799443 James Kublin Preventive Medicine 1100 Fairview Ave N # E3-300, Seattle, WA 98109-4433 2014-03-31
1679918031 Richard L. Rysdam Preventive Medicine 4742 42nd Ave Sw # 292, Seattle, WA 98116-4553 2013-04-29
1275886533 Ashley Hedeen Preventive Medicine 1400 N 143rd St, Seattle, WA 98133-7102 2012-10-23
1821354069 Aristotle Sun Preventive Medicine 3915 Talbot Rd S Ste 104, Renton, WA 98055-5738 2012-04-02
1760756563 Reimert Thorolf Ravenholt Preventive Medicine 3156 E Laurelhurst Dr Ne, Seattle, WA 98105-5333 2012-02-27
1124316641 Steven Dale Helgerson Preventive Medicine 601 Belmont Ave E, Suite F11, Seattle, WA 98102-4875 2011-07-18
1194054247 Lewis B Rock IIi Preventive Medicine 2375 30th Ave Ne, Issaquah, WA 98029-3618 2009-12-21
1609047810 Paul Howard Stepak Preventive Medicine 15300 Bothell Way Ne, Lake Forest Park, WA 98155-7634 2008-03-14
1326253501 Kristin Elise Erickson Preventive Medicine 9040 Jackson Ave Medical Evaluation Board, Tacoma, WA 98431-0001 2007-05-11
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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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