COWLITZ INDIAN TRIBE


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

COWLITZ INDIAN TRIBE (NPI# 1740562909) 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) 1740562909
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 3605751948
Mailing Telephone 3605758275
Mailing Fax Number 3605751950
Enumeration Date 2011-09-14
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 261Q00000X Clinic/Center 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
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 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 261Q00000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center

Taxonomy Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1619274776 Texas Spine & Joint Hospital Longview Clinic Clinic/Center 725 N 4th St, Longview, TX 75601-5412 2011-02-24
1346206786 Isn Sleep Center of East Texas, LLC Clinic/Center 109 W Hoyt Dr, Longview, TX 75601-3614 2006-04-25
1043209919 Special Health Resources for Texas, Inc Clinic/Center 410 N 4th St, Longview, TX 75601-6511 2005-10-13
1487206900 Etx Chiropractic, Inc Clinic/Center 1121 Evergreen St, Longview, TX 75604-2130 2019-07-15
1164930905 Ideal Option, Pllc Clinic/Center 1004 Fir St, Longview, WA 98632-2527 2018-01-15
1932567161 Spine and Whiplash Center, Inc. Clinic/Center 1552 Broadway St, Longview, WA 98632-3716 2016-02-02
1184019184 Kidspace Therapy, LLC Clinic/Center 2145 Tibbetts Dr Ste A, Longview, WA 98632-4211 2015-04-06
1043515091 Family Focus Wellness Center Clinic/Center 101b Woodbine Pl, Longview, TX 75601-2912 2011-01-24
1891012316 Providence Health & Services - Oregon Clinic/Center 625 9th Ave, Suite 120, Longview, WA 98632-2465 2010-04-23
1891010310 Healthcare Express, LLP Clinic/Center 1509 W Loop 281, Longview, TX 75604-2820 2010-03-29
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Competitor

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City LONGVIEW
Zip Code 98632

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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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