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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WA | 1981224 | 05 |
Other Name | Type Code |
---|---|
Cowlitz Indian Tribal Health Services | Other Name - Individual/Organization |
Address | Telephone Number | Fax Number |
---|---|---|
1044 11th Ave, Suite A, Longview, WA 986322506 | 3605758275 | 3605751950 |
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 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | COWLITZ INDIAN TRIBE | 1055 9th Ave Ste B, Longview, WA 98632-2661 |
Street Address |
922 FIR ST |
City | LONGVIEW |
State | WA |
Zip Code | 98632 |
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 |
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 |
Find all providers in zip 98632 |
Taxonomy Code | 2083P0901X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Preventive Medicine |
Specialization | Public Health & General Preventive Medicine |
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. |
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 |
Find all providers with the same taxonomy |
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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.