OrganizationActive
Cowlitz Indian Tribe
NPI 1972962165 · Public Health & General Preventive Medicine Physician · Vancouver, WA
Provider details
- NPI number
- 1972962165
- 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
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
7700 Ne 26th Ave
Vancouver, WA 98665-0672
Phone: (360) 397-8228
Fax: (360) 575-1950
Street-level locationGet directions
Mailing address
Po Box 2429
Longview, WA 98632-8486
Other names (DBA / former)
- Other name
- Cowlitz Indian Tribal Health Services
Registry dates
- Enumerated
- 2016-02-16
- Last updated
- 2023-02-03
- Certified
- 2023-02-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.