| Cowlitz Tribal Treatment | |
|
900 Fir St Longview WA 98632 | |
| (360) 575-8275 | |
| Not Available |
| Full Name | Cowlitz Tribal Treatment |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 900 Fir St, Longview, Washington |
| Authorized Official Name and Position | Shavon Keller (BILLING SUPERVISOR) |
| Authorized Official Contact | 3603539431 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cowlitz Tribal Treatment Po Box 2429 Longview WA 98632-8486 Ph: (360) 575-8275 | Cowlitz Tribal Treatment 900 Fir St Longview WA 98632 Ph: (360) 575-8275 |
| NPI Number | 1528285038 |
|---|---|
| Provider Enumeration Date | 04/19/2007 |
| Last Update Date | 10/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528285038 | NPI | - | NPPES |
| 1994987 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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