COWLITZ INDIAN TRIBE NPI 1538412630

NPI Information

NPI: 1538412630
Provider Name: COWLITZ INDIAN TRIBE
Classification: Clinic/Center - 261QR0405X
Specialization: Rehabilitation, Substance Use Disorder
Entity Type: Organization
:
CLIA Number: 50D2207612
Address: 7105 NE 40TH ST
VANCOUVER, WA
ZIP 98661
Phone: (360) 353-9431

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NPI Details

COWLITZ INDIAN TRIBE is a rehabilitation and substance use disorder clinic center in Vancouver, WA. COWLITZ INDIAN TRIBE NPI is 1538412630. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

7105 NE 40TH ST
VANCOUVER, WA
ZIP 98661-058
Phone: (360) 353-9431
Fax: (360) 353-9440

The provider's authorized official is Shavon Keller .
The authorized official title is Billing Supervisor and has the following contact phone number (360) 353-9431.

The CLIA number assigned to this NPI record is 50D2207612 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/26/2012 and was last updated on 10/2/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	261QM2800X	Clinic/Center	Methadone	No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
3	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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