OrganizationActive
Cowlitz Indian Tribe
NPI 1164649679 · Substance Use Disorder Rehabilitation Clinic/Center · Vancouver, WA
Provider details
- NPI number
- 1164649679
- Entity type
- Organization
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Cowlitz Indian Tribe
- Organization subpart
- Yes
- Authorized official
- Shavon Keller, Billing Supervisor(360) 353-9431
Specialties & taxonomies
Ambulatory Health Care Facilities
- General Practice Physician208D00000X
Allopathic & Osteopathic Physicians
Practice location
7700 Ne 26th Ave
Vancouver, WA 98665-0672
Phone: (360) 397-8228
Fax: (360) 575-1950
Approximate (ZIP-level) locationGet directions
Mailing address
P.o. Box 2429
Longview, WA 98632
Other names (DBA / former)
- Other name
- Cowlitz Tribal Treatment
Additional practice locations (1)
- 900 Fir StLongview, WA 98632-2544Phone: (360) 575-3316
Registry dates
- Enumerated
- 2007-04-19
- Last updated
- 2024-07-22
- Certified
- 2024-07-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.