DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: COWLITZ INDIAN TRIBE

MEDICARE: COWLITZ INDIAN TRIBE
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
1208D00000XGeneral Practice Physician
2261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number : 1164649679
Entity Type Code : Organization
Provider Name (Legal Business Name) : COWLITZ INDIAN TRIBE
Provider Business Mailing Address
First Line : P.O. BOX 2429
Second Line :
City : LONGVIEW
State : WA
Zip : 98632
Country : US
Telephone Number : 360-397-8228
Fax Number : 360-575-1950
Provider Business Practice Location Address
First Line : 7700 NE 26TH AVE
Second Line :
City : VANCOUVER
State : WA
Zip : 98665-0672
Country : US
Telephone Number : 360-397-8228
Fax Number : 360-575-1950
Authorized Official
Title or Position : BILLING SUPERVISOR
Name : SHAVON KELLER
Credential :
Telephone Number : 360-353-9431
Provider Enumeration Date : 04/19/2007
Last Update Date : 07/22/2024

Similar Medicare Providers

1063787216 — DAVID ALDEN PULLIAM LMHC
Practice Location Address:
7700 NE 26TH AVE
VANCOUVER, WA
98665-0672
Practice Phone: 360-397-8228
Practice Fax:
1114246535 — CHRISTOPHER TODD LAKE MPH,CDP
Practice Location Address:
7700 NE 26TH AVE
VANCOUVER, WA
98665-0672
Practice Phone: 360-397-8228
Practice Fax: 360-397-8259
1104261817 — KARA D FRIZZELL
Practice Location Address:
7700 NE 26TH AVE
VANCOUVER, WA
98665-0672
Practice Phone: 360-397-8228
Practice Fax:
1629462726 — ALLISON LYNN JONES MA
Practice Location Address:
7700 NE 26TH AVE
VANCOUVER, WA
98665-0672
Practice Phone: 360-397-8228
Practice Fax:
1972962165 — COWLITZ INDIAN TRIBE
Practice Location Address:
7700 NE 26TH AVE
VANCOUVER, WA
98665-0672
Practice Phone: 360-397-8228
Practice Fax: 360-575-1950
1760845853 — JENNIFER FRESH PMHNP, ARNP
Practice Location Address:
7700 NE 26TH AVE
VANCOUVER, WA
98665-0672
Practice Phone: 360-397-8228
Practice Fax: 360-353-9440

Directions to “COWLITZ INDIAN TRIBE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.