| Cowlitz Family Health Center | |
|
1057 12th Ave Longview WA 98632-2509 | |
| (360) 636-3892 | |
| (360) 414-1114 |
| Full Name | Cowlitz Family Health Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1057 12th Ave, Longview, Washington |
| Authorized Official Name and Position | James Coffee (CEO) |
| Authorized Official Contact | 3606363892 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice 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 Number | 1184824203 |
|---|---|
| Provider Enumeration Date | 07/18/2007 |
| Last Update Date | 05/31/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184824203 | NPI | - | NPPES |
| 5033980 | Medicaid | WA | DENTAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Lance D Brigman, Md, Ps Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1004 Fir St, Longview, WA 98632 Phone: 360-423-6110 Fax: 360-423-8078 | |
Cowlitz Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1057 12th Ave, Longview, WA 98632 Phone: 360-636-3892 Fax: 360-414-1114 | |
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