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
1261QH0100XHealth Service Clinic/Center
2261QP2300XPrimary Care Clinic/Center

Other Identifiers

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

General Provider Information

NPI Number : 1346465101
Entity Type Code : Organization
Provider Name (Legal Business Name) : COWLITZ INDIAN TRIBE
Provider Business Mailing Address
First Line : PO BOX 2429
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-8486
Country : US
Telephone Number : 360-575-8275
Fax Number : 360-575-1950
Provider Business Practice Location Address
First Line : 1044 11TH AVE
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-2506
Country : US
Telephone Number : 360-575-8275
Fax Number : 360-575-1950
Authorized Official
Title or Position : BILLING SUPERVISOR
Name : SHAVON KELLER
Credential :
Telephone Number : 360-353-9431
Provider Enumeration Date : 04/16/2007
Last Update Date : 03/22/2018

Similar Medicare Providers

1356727069 — ELISABETH ANNE HANSEN FNP-C
Practice Location Address:
1044 11TH AVE
LONGVIEW, WA
98632-2506
Practice Phone: 360-575-8275
Practice Fax: 360-575-1943
1851347454 — JOYCE ELAINE TOBIAS APRN
Practice Location Address:
1044 11TH AVE , SUITE A
LONGVIEW, WA
98632-2506
Practice Phone: 360-575-8275
Practice Fax: 360-575-1948
1871652255 — MELISSA NICOLE KIRK R.D., C.D., C.D.E.
Practice Location Address:
1044 11TH AVE
LONGVIEW, WA
98632-2506
Practice Phone: 360-353-9432
Practice Fax: 360-353-9440
1467508341 — CHARLETTA LEA LEWIS ARNP
Practice Location Address:
1044 11TH AVE
LONGVIEW, WA
98632-2506
Practice Phone: 360-353-9422
Practice Fax: 360-353-9526
1386824266 — MRS. CHEYNEY WEBB LINDGREN ARNP
Practice Location Address:
1044 11TH AVE
LONGVIEW, WA
98632-2506
Practice Phone: 360-575-8275
Practice Fax: 360-575-1950
1407018997 — SYBIL M IVERSON CDP
Practice Location Address:
1044 11TH AVE
LONGVIEW, WA
98632-2506
Practice Phone: 360-575-3316
Practice Fax: 360-423-7813

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.