Cowlitz Indian Tribe
NPI 1619194123 · Public Health & General Preventive Medicine Physician · Longview, WA
Provider details
- NPI number
- 1619194123
- Entity type
- Organization
- Primary specialty
- Public Health & General Preventive Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Cowlitz Indian Tribe
- Organization subpart
- Yes
- Authorized official
- Shavon Keller, Billing Supervisor(360) 353-9431
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Health Service Clinic/Center261QH0100X
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
6 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Other name
- Cowlitz Indian Tribal Health Services
Additional practice locations (5)
- 1000 Davis PlDupont, WA 98327-8781Phone: (360) 946-2498
- 1044 11th AveSuite aLongview, WA 98632-2506Phone: (360) 575-8275Fax: (360) 575-1950
- 15455 65th Ave STukwila, WA 98188-2534Phone: (206) 721-5170
- 6450 Southcenter BlvdTukwila, WA 98188-2552Phone: (206) 466-5410
- 7700 Ne 26th AveVancouver, WA 98665-0672Phone: (360) 397-8228
Registry dates
- Enumerated
- 2007-04-19
- Last updated
- 2024-10-31
- Certified
- 2024-10-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.