COWLITZ INDIAN TRIBE (NPI# 1225382328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225382328 |
| Entity Type | Organization |
| Organization Name | COWLITZ INDIAN TRIBE |
| Other Organization Name | COWLITZ TRIBAL HEALTH SERVICES |
| Practice Address |
15455 65th Ave S Tukwila WA 98188 |
| Mailing Address |
Po Box 2429 Longview WA 98632-8486 |
| Practice Telephone | 2067215170 |
| Practice Fax Number | 2067216288 |
| Mailing Telephone | 2067215170 |
| Mailing Fax Number | 2067216288 |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2018-08-22 |
| Authorized Official Name | SHAVON KELLER (BILLING SUPERVISOR) |
| Authorized Official Telephone | 3603539431 |
| Is Organization Subpart | Y |
| Parent Organization Name | COWLITZ INDIAN TRIBE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities | ||
| Y | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Cowlitz Tribal Health Services | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6450 Southcenter Blvd, Tukwila, WA 981882552 | 2067215170 | 3603539440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861722258 | Cowlitz Indian Tribe | Clinic/Center | 107 Spencer Rd, Toledo, WA 98591 | 2010-01-06 |
| 1164649679 | Cowlitz Indian Tribe | Clinic/Center | 7700 Ne 26th Ave, Vancouver, WA 98665-0672 | 2007-04-19 |
| 1972962165 | Cowlitz Indian Tribe | Clinic/Center | 7700 Ne 26th Ave, Vancouver, WA 98665-0672 | 2016-02-16 |
| 1538412630 | Cowlitz Indian Tribe | Clinic/Center | 15455 65th Ave S, Tukwila, WA 98188 | 2012-10-26 |
| 1740562909 | Cowlitz Indian Tribe | Clinic/Center | 1044 11th Ave, Longview, WA 98632-2506 | 2011-09-14 |
| 1619194123 | Cowlitz Indian Tribe | Clinic/Center | 922 Fir St, Longview, WA 98632 | 2007-04-19 |
| 1528285038 | Cowlitz Indian Tribe | Clinic/Center | 900 Fir St, Longview, WA 98632 | 2007-04-19 |
| 1346465101 | Cowlitz Indian Tribe | Clinic/Center | 1044 11th Ave, Longview, WA 98632-2506 | 2007-04-16 |
| 1851328447 | Cowlitz Indian Tribe | Clinic/Center | 1044 11th Ave, Longview, WA 98632 | 2006-06-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COWLITZ INDIAN TRIBE | 1055 9th Ave Ste B, Longview, WA 98632-2661 |
| Street Address |
15455 65TH AVE S |
| City | TUKWILA |
| State | WA |
| Zip Code | 98188 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912078361 | Eduardo Abuyog | Social Worker | 15455 65th Ave S, Tukwila, WA 98188-2534 | 2006-11-09 |
| 1720637424 | Tara Lynn Taylor | Registered Nurse | 15455 65th Ave S, Tukwila, WA 98188-2534 | 2019-09-05 |
| 1326509597 | Gabrielle Gutierrez | Registered Nurse | 15455 65th Ave S, Tukwila, WA 98188-2534 | 2019-03-28 |
| 1083184097 | Fredy E Cortez | Counselor | 15455 65th Ave S, Tukwila, WA 98188-2534 | 2018-12-03 |
| 1689142903 | Ingrid Buchan | Counselor | 15455 65th Ave S, Tukwila, WA 98188-2534 | 2018-11-05 |
| 1407323942 | Michele Marie Perrin | Counselor | 15455 65th Ave S, Tukwila, WA 98188-2534 | 2018-11-01 |
| 1194205609 | Stephanie Marie Degroat | Social Worker | 15455 65th Ave S, Tukwila, WA 98188 | 2018-08-15 |
| 1689150997 | Tate J Bates | Social Worker | 15455 65th Ave S, Tukwila, WA 98188 | 2018-07-19 |
| 1235624487 | Robert Jay Ramirez | Social Worker | 15455 65th Ave S, Tukwila, WA 98188-2534 | 2018-06-28 |
| 1629561634 | Sandra S Baker | Social Worker | 15455 65th Ave S, Tukwila, WA 98188-2534 | 2018-06-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194342774 | Yemisirach Fikru Tufa | Registered Nurse | 3039 S 154th St, Aptb304, Seatac, WA 98188 | 2020-06-30 |
| 1841756608 | Silvia Ruby Campos | Behavior Technician | 651 Stander Blvd., Suite 112, Tukwila, WA 98188 | 2019-02-18 |
| 1720562036 | Alissa Hayes | Counselor | 631 Strander Bvd. Ste A., Tukwila, WA 98188 | 2018-09-21 |
| 1457859035 | Bashayer S Albadr | Student in an Organized Health Care Education/Training Program | 6100 South Center Blvd. 3rd Floor, Tukwila, WA 98188 | 2018-01-29 |
| 1356855522 | Miguel Angel Banos | Massage Therapist | 3000 Ne 4th St., Renton, WA 98188 | 2017-11-27 |
| 1801312061 | Emma Sinclair Jennings | Counselor | 651 Strander Blvd. Suite 105, Tukwila, WA 98188 | 2017-08-19 |
| 1518417526 | Jamila Fyrouz Iraqui | Counselor | 15142 65th Ave S, Apt. 312, Tukwila, WASHINGTON 98188 | 2016-10-13 |
| 1487026076 | Catholic Community Services of Western Washington | Clinic/Center | 631 Strander Blvd Ste A, Tukwila, WA 98188 | 2015-10-22 |
| 1659773174 | Thanh Thi-hong Nguyen | Physician Assistant | 3739 S 191st Pl, Seatac, WA 98188 | 2014-09-16 |
| 1053725101 | Affinity Home Care Services Inc | In Home Supportive Care | 601 Strander Blvd, Tukwila, WA 98188 | 2014-06-17 |
| Find all providers in zip 98188 | ||||
| Taxonomy Code | 2083P0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Public Health & General Preventive Medicine |
| Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851840508 | Kimquy Kieu | Preventive Medicine | 711 24th Ave S, Seattle, WA 98144-3003 | 2016-09-22 |
| 1659799443 | James Kublin | Preventive Medicine | 1100 Fairview Ave N # E3-300, Seattle, WA 98109-4433 | 2014-03-31 |
| 1679918031 | Richard L. Rysdam | Preventive Medicine | 4742 42nd Ave Sw # 292, Seattle, WA 98116-4553 | 2013-04-29 |
| 1275886533 | Ashley Hedeen | Preventive Medicine | 1400 N 143rd St, Seattle, WA 98133-7102 | 2012-10-23 |
| 1821354069 | Aristotle Sun | Preventive Medicine | 3915 Talbot Rd S Ste 104, Renton, WA 98055-5738 | 2012-04-02 |
| 1760756563 | Reimert Thorolf Ravenholt | Preventive Medicine | 3156 E Laurelhurst Dr Ne, Seattle, WA 98105-5333 | 2012-02-27 |
| 1124316641 | Steven Dale Helgerson | Preventive Medicine | 601 Belmont Ave E, Suite F11, Seattle, WA 98102-4875 | 2011-07-18 |
| 1194054247 | Lewis B Rock IIi | Preventive Medicine | 2375 30th Ave Ne, Issaquah, WA 98029-3618 | 2009-12-21 |
| 1609047810 | Paul Howard Stepak | Preventive Medicine | 15300 Bothell Way Ne, Lake Forest Park, WA 98155-7634 | 2008-03-14 |
| 1326253501 | Kristin Elise Erickson | Preventive Medicine | 9040 Jackson Ave Medical Evaluation Board, Tacoma, WA 98431-0001 | 2007-05-11 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on COWLITZ INDIAN TRIBE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.