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NPI Code Detail

MEDICARE: COWLITZ FAMILY HEALTH CENTER

MEDICARE: COWLITZ FAMILY HEALTH CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation FacilityWA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972726867
Entity Type Code : Organization
Provider Name (Legal Business Name) : COWLITZ FAMILY HEALTH CENTER
Provider Business Mailing Address
First Line : 1057 12TH AVE
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-2509
Country : US
Telephone Number : 360-636-3892
Fax Number : 360-232-8400
Provider Business Practice Location Address
First Line : 2232 S SILVER LAKE RD
Second Line :
City : CASTLE ROCK
State : WA
Zip : 98611-8021
Country : US
Telephone Number : 360-274-3262
Fax Number : 360-274-3345
Authorized Official
Title or Position : CEO
Name : JAMES K COFFEE
Credential : CEO
Telephone Number : 360-636-3892
Provider Enumeration Date : 04/10/2007
Last Update Date : 02/27/2023

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Directions to “COWLITZ FAMILY HEALTH CENTER ” Practice Location

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