Cowlitz Family Health Center - Medicare Dental Clinic in Longview, WA

Cowlitz Family Health Center is a medicare enrolled dental clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Longview, Washington. The current practice location for Cowlitz Family Health Center is 1057 12th Ave, Longview, Washington. For appointments, you can reach them via phone at (360) 636-3892. The mailing address for Cowlitz Family Health Center is 1057 12th Ave, Longview, Washington and phone number is (360) 636-3892.

Cowlitz Family Health Center is licensed to practice in Washington (license number ). The clinic also participates in the medicare program and its NPI number is 1891724506. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (360) 636-3892.

Contact Information

Cowlitz Family Health Center
1057 12th Ave
Longview
WA 98632-2509
(360) 636-3892
(360) 414-1342

Map and Direction


Dental Care Clinic Profile

Full NameCowlitz Family Health Center
SpecialityClinic/Center
Location1057 12th Ave, Longview, Washington
Authorized Official Name and PositionJames K Coffee (CEO)
Authorized Official Contact3603535803
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Cowlitz Family Health Center
1057 12th Ave
Longview
WA 98632-2509

Ph: (360) 636-3892
Cowlitz Family Health Center
1057 12th Ave
Longview
WA 98632-2509

Ph: (360) 636-3892

NPI Details:

NPI Number1891724506
Provider Enumeration Date07/03/2006
Last Update Date05/24/2024

Medicare PECOS Information:

Medicare PECOS PAC ID5991696395
Medicare Enrollment IDO20040324000330

Medical Identifiers

Medical identifiers for Cowlitz Family Health Center such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1891724506NPI-NPPES
7407349MedicaidWA
5033980MedicaidWA
1437359551MedicaidWA
7086523MedicaidWA
7900426MedicaidWA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QD0000XClinic/center - Dental (Washington)Secondary
261QF0050XClinic/center - Family Planning, Non-surgical (Washington)Secondary
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) (Washington)Primary
261QM0850XClinic/center - Adult Mental Health (* (Not Available))Secondary
261QM0855XClinic/center - Adolescent And Children Mental Health (* (Not Available))Secondary
261QP2300XClinic/center - Primary Care (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Cowlitz Family Health Center acts as a billing entity for following providers:
Provider NameGerardo R Melgar
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1619903820
PECOS PAC ID: 9537176920
Enrollment ID: I20060309000300
Provider NameStephanie G Wesztergom
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1497715882
PECOS PAC ID: 7719955889
Enrollment ID: I20080108000583
Provider NameTresha M Carroll
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1932132552
PECOS PAC ID: 6103940234
Enrollment ID: I20100826000562
Provider NameGail S Conway
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1386669711
PECOS PAC ID: 5799809836
Enrollment ID: I20100826000753
Provider NameSeth M Mercurio
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1821340530
PECOS PAC ID: 1951555382
Enrollment ID: I20130211000579
Provider NameAnthony L Reyes
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1588877799
PECOS PAC ID: 6507051471
Enrollment ID: I20130513000083
Provider NameSean N Murray
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1265662233
PECOS PAC ID: 5799964763
Enrollment ID: I20170126001417
Provider NameKaelie C Murray
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760864862
PECOS PAC ID: 6103103916
Enrollment ID: I20170504000762
Provider NameKristie M Andreas
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124308408
PECOS PAC ID: 8426375221
Enrollment ID: I20170517002088
Provider NameBrandon C Bosch
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1902203367
PECOS PAC ID: 6305104860
Enrollment ID: I20171211002808
Provider NameAdreia Jessop
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1972021087
PECOS PAC ID: 4183977028
Enrollment ID: I20181023003191
Provider NameDanielle R Glover-cloutier
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245726694
PECOS PAC ID: 3870837180
Enrollment ID: I20181127002232
Provider NameWinnet K Katiyo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992280796
PECOS PAC ID: 8921346297
Enrollment ID: I20190212000920
Provider NameMin Kuk Lee
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1548693104
PECOS PAC ID: 2264713379
Enrollment ID: I20190829002976
Provider NameStephanie Dianne Baxter
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1952965279
PECOS PAC ID: 9638500580
Enrollment ID: I20200511001344
Provider NameMelissa Lee
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205349602
PECOS PAC ID: 6103233648
Enrollment ID: I20210329001363
Provider NameMadeline Marie Ferone
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790266609
PECOS PAC ID: 5890174130
Enrollment ID: I20220616002818
Provider NamePamela Anne Martin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538705322
PECOS PAC ID: 9830567429
Enrollment ID: I20221202000628
Provider NameBethany L Madden
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104691658
PECOS PAC ID: 0941659718
Enrollment ID: I20231206001121
Provider NameLisabeth Stolp
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1962270330
PECOS PAC ID: 8325485840
Enrollment ID: I20240320001148

Reviews and Comments


Dental Clinics in Longview, WA

Longview-kelso Dental Office
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Medicare: Not Enrolled in Medicare
Practice Location: 1230 7th Ave, Longview, WA 98632
Phone: 800-813-2000    Fax: 503-286-6879
Smiles Dental
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Medicare: Not Enrolled in Medicare
Practice Location: 820 Ocean Beach Hwy, Suite 110, Longview, WA 98632
Phone: 360-577-0566    Fax: 360-423-3343
Harbor Kids Dental & Orthodontics
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Medicare: Not Enrolled in Medicare
Practice Location: 900 Ocean Beach Hwy Ste A, Longview, WA 98632
Phone: 253-759-5437    Fax: 253-426-1836
Matthew E Lesh Dmd Pc
Dental Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 950 14th Ave, Longview, WA 98632
Phone: 360-200-4924    
Dream Dentistry
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Medicare: Not Enrolled in Medicare
Practice Location: 950 14th Ave, Longview, WA 98632
Phone: 360-200-4924    Fax: 360-200-4923
Cowlitz Periodontal Care & Implant Surgary
Dental Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1703 Hudson St, Longview, WA 98632
Phone: 360-423-8000    
Dr Azizi Pllc
Dental Clinic
Medicare: Medicare Enrolled
Practice Location: 1538 11th Ave, Longview, WA 98632
Phone: 323-804-1324    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.