COWLITZ FAMILY HEALTH CENTER (NPI# 1801266481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801266481 |
| Entity Type | Organization |
| Organization Name | COWLITZ FAMILY HEALTH CENTER |
| Other Organization Name | FAMILY HEALTH CENTER CASTLE ROCK CLINIC |
| Practice Address |
139 1st Ave Sw Castle Rock WA 98611 |
| Mailing Address |
1057 12th Ave Longview WA 98632-2509 |
| Practice Telephone | 3606366920 |
| Practice Fax Number | 3602742354 |
| Mailing Telephone | 3606363892 |
| Mailing Fax Number | 3602328400 |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2020-05-20 |
| Authorized Official Name | DIAN COOPER (CEO) |
| Authorized Official Telephone | 3606363892 |
| Is Organization Subpart | Y |
| Parent Organization Name | COWLITZ FAMILY HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0050X |
Clinic/Center Specialization: Family Planning, Non-Surgical |
600176084 | WA | Ambulatory Health Care Facilities |
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
600176084 | WA | Ambulatory Health Care Facilities |
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
600176084 | WA | Ambulatory Health Care Facilities |
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
600176084 | WA | Ambulatory Health Care Facilities |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
600176084 | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1437359551 | 05 | |
| WA | 7086523 | 05 | |
| WA | 7900426 | 05 |
| Other Name | Type Code |
|---|---|
| Family Health Center Castle Rock Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053472993 | Cowlitz Family Health Center | Clinic/Center | 1251 Lewis River Rd Ste D, Woodland, WA 98674-9203 | 2006-12-13 |
| 1962876748 | Cowlitz Family Health Center | Clinic/Center | 784 14th Ave, Longview, WA 98632-2315 | 2015-11-17 |
| 1376910885 | Cowlitz Family Health Center | Community/Behavioral Health | 1057 12th Ave, Longview, WA 98632-2509 | 2015-09-01 |
| 1104243534 | Cowlitz Family Health Center | Clinic/Center | 621 Grade St, Kelso, WA 98626-2606 | 2014-03-24 |
| 1366790008 | Cowlitz Family Health Center | Clinic/Center | 300 Oak St Ste B, Kelso, WA 98626-2304 | 2012-08-28 |
| 1538497417 | Cowlitz Family Health Center | Clinic/Center | 335 Una Ave, Cathlamet, WA 98612-9583 | 2009-12-03 |
| 1184824203 | Cowlitz Family Health Center | Clinic/Center | 1057 12th Ave, Longview, WA 98632-2509 | 2007-07-18 |
| 1437359551 | Cowlitz Family Health Center | Case Management | 1057 12th Ave, Longview, WA 98632-2509 | 2007-07-18 |
| 1700086824 | Cowlitz Family Health Center | Clinic/Center | 1057 12th Ave, Longview, WA 98632-2509 | 2007-07-18 |
| 1073711081 | Cowlitz Family Health Center | Clinic/Center | 1057 12th Ave, Longview, WA 98632-2509 | 2007-07-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | COWLITZ FAMILY HEALTH CENTER | 1057 12th Ave, Longview, WA 98632-2509 |
| Street Address |
139 1ST AVE SW |
| City | CASTLE ROCK |
| State | WA |
| Zip Code | 98611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962496083 | Beverly M Search | Registered Nurse | 139 1st Ave Sw, Castle Rock, WA 98611 | 2005-09-02 |
| 1548693104 | Min Kuk Lee | Family Medicine | 139 1st Ave Sw, Castle Rock, WA 98611 | 2013-08-17 |
| 1003134834 | Peacehealth | Durable Medical Equipment & Medical Supplies | 139 1st Ave Sw, Castle Rock, WA 98611 | 2010-05-04 |
| 1730126277 | Reinhild Elisabeth Ayoub | Pediatrics | 139 1st Ave Sw, Castle Rock, WA 98611 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942568522 | Almost Angels Home Care Agency, LLC | In Home Supportive Care | 211 Front Ave Sw, Castle Rock, WA 98611 | 2012-05-02 |
| 1922204866 | Emma V Torres Baltazar Md Pllc | Family Medicine | 606 Se Roake Avenue, Castle Rock, WA 98611 | 2007-06-26 |
| 1417002064 | Crystal L Davis | Massage Therapist | 139 1st Ave. Sw, Castle Rock, WA 98611 | 2007-01-24 |
| 1134284060 | Pt Northwest of Longview Inc | Physical Therapist | 20 Cowlitz, Castle Rock, WA 98611 | 2006-12-22 |
| 1306857800 | Castle Rock Pharmacy Inc | Pharmacy | 117 1st Sw, Castle Rock, WA 98611 | 2006-08-10 |
| 1619901592 | Emma V. Torres-baltazar | Family Medicine | 606 Se Roake St. / Avenue, Castle Rock Medical Clinic, Castle Rock, WA 98611 | 2006-07-10 |
| 1427005164 | Gregory Loren Finkas | Chiropractor | 1254 Mt St Helens Way Ne, Suite E, Castle Rock, WA 98611 | 2006-05-28 |
| 1164490058 | City of Castle Rock | Ambulance | 146 A Street Sw, Castle Rock, WA 98611 | 2006-03-08 |
| 1235623844 | Tina M Pond | Registered Nurse | 2232 S Silver Lake Rd, Castle Rock, WA 98611 | 2018-06-18 |
| 1194815589 | Cowlitz County Fire District 6 | Ambulance | 146 A St, Castle Rock, WA 98611-0030 | 2006-10-13 |
| Find all providers in zip 98611 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1144703885 | Healthpoint | Clinic/Center | 219 State Ave N, Ste 100, Kent, WA 98030 | 2018-09-10 |
| Find all providers with the same taxonomy | ||||
| City | CASTLE ROCK |
| Zip Code | 98611 |
Please comment or provide details below to improve the information on COWLITZ FAMILY HEALTH CENTER.
| 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.