Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Cowlitz Indian Tribe

Organization General Practice Physician · NPI 1164649679

Cowlitz Indian Tribe is a General Practice Physician in Vancouver, Washington. Works from 2 locations. Registered with an NPI since 2007.

In the registry since
2007
Specialties on file
2

Practice location Address checks out

7700 NE 26th Ave
Vancouver, WA 98665-0672
Phone: (360) 397-8228
Fax: (360) 575-1950
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 900 Fir St, Longview, WA 98632-2544 — (360) 575-3316

Specialties & licences

Substance Use Disorder Rehabilitation Clinic/Center (primary) Taxonomy 261QR0405X
General Practice Physician Taxonomy 208D00000X

Record details

NPI number1164649679
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCowlitz Indian Tribe
Authorized official Shavon Keller — Billing Supervisor · (360) 353-9431
Other names Cowlitz Tribal Treatment
NPI enumeratedApril 19, 2007
Last updated in NPPESJuly 22, 2024
Certification dateJuly 22, 2024
Mailing addressP.O. Box 2429, Longview, WA 98632

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