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COWLITZ INDIAN TRIBAL HEALTH SERVICES
NPI 1740562909
Clinic/Center in Longview, WA

Active since September 14, 2011
1044 11TH AVE, LONGVIEW, WA 98632(360) 575-8275(360) 575-1948 Get Directions Write a Review

NPPES record last updated: March 22, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 22, 2018, Mar 16, 2018, Jan 25, 2016 (3 updates tracked since 2016).

About Cowlitz Indian Tribal Health Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COWLITZ INDIAN TRIBAL HEALTH SERVICES (NPI 1740562909) is a healthcare organization registered as a clinic/center in Longview, Washington and active in the NPI registry since September 2011. The organization lists Shavon Keller, Billing Supervisor, as its authorized official.

NPPES Registry Identity

NPI1740562909
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameCOWLITZ INDIAN TRIBE
Location Address1044 11TH AVELongview, WA 98632-2506
Mailing AddressPo Box 2429Longview, WA 98632-8486 · (360) 575-8275 · Fax (360) 575-1950
Phone(360) 575-8275
Fax(360) 575-1948
Organization SubpartNo
Authorized OfficialShavon KellerBilling Supervisor · (360) 353-9431
Enumeration DateSeptember 14, 2011
Last NPPES UpdateMarch 22, 20183 updates tracked since enumeration
✔ NPI 1740562909 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Also ListedClinic/Center · Health ServiceTaxonomy 261QH0100X
1044 11TH AVE, Longview, WA 98632
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Other Names 1

Other NameCowlitz Indian Tribal Health Services

Other Identifiers 1

Medicaid7122898WA

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Cowlitz Indian Tribal Health Services is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

44

Medicare enrollment records show 44 clinicians reassign Medicare billing to Cowlitz Indian Tribal Health Services, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 10 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 9

Mental Health Counselor12
Clinical Social Worker11
Nurse Practitioner11
Family Practice3
Marriage and Family Therapist3
Addiction Medicine1
Internal Medicine1
Psychiatry1
1 other specialty1

Nearest to this location (20)

See all 44
Candace Markley, MD, MPH
Family Practice
NPI 1770013005
1044 11TH AVE
Longview, WA 98632
(360) 575-8275
✔ PECOS✔ Accepts MedicareSame address
Celia Delaney, MA
Mental Health Counselor
NPI 1033508064
1044 11TH AVE
Longview, WA 98632
(360) 353-9431
✔ PECOSSame address
Elisabeth Hansen, FNP-C
Nurse Practitioner
NPI 1356727069
1044 11TH AVE
Longview, WA 98632
(360) 575-8275
✔ PECOS✔ Accepts MedicareSame address
Kenneth Hermansen, RDN, CDCES
Registered Dietitian or Nutrition Professional
NPI 1558068791
1044 11TH AVE
Longview, WA 98632
(360) 575-8275
✔ Accepts MedicareSame address
Maegan Bolin, LMHC, CDP
Mental Health Counselor
NPI 1558804997
922 FIR ST
Longview, WA 98632
(360) 353-9422
✔ PECOS✔ Accepts Medicare0.1 mi
Samuel Tuckwin, LCSW
Clinical Social Worker
NPI 1669161014
900 FIR ST
Longview, WA 98632
(360) 353-9422
✔ PECOS✔ Accepts Medicare0.1 mi
Jesse Cho
Nurse Practitioner
NPI 1104561398
900 FIR ST
Longview, WA 98632
(949) 878-8315
✔ PECOS✔ Accepts Medicare0.1 mi
Kelsey Gravelle, SUDP LICSW
Clinical Social Worker
NPI 1952840944
900 FIR ST
Longview, WA 98632
(360) 575-3316
✔ PECOS✔ Accepts Medicare0.1 mi
Kristine Rister, LICSW, SUDP
Clinical Social Worker
NPI 1568701530
900 FIR ST
Longview, WA 98632
(360) 353-9422
✔ PECOS✔ Accepts Medicare0.1 mi
Lynelle Noisy Hawk, MD
Family Practice
NPI 1881894152
PO BOX 2429
Longview, WA 98632
(360) 353-9494
✔ PECOS✔ Accepts Medicare6.9 mi
Jennifer Fresh, PMHNP, ARNP
Nurse Practitioner
NPI 1760845853
7700 NE 26TH AVE
Vancouver, WA 98665
(360) 397-8228
✔ PECOS✔ Accepts Medicare34 mi
Allison Jones, MA
Mental Health Counselor
NPI 1629462726
7700 NE 26TH AVE
Vancouver, WA 98665
(360) 397-8228
✔ PECOS34 mi
David Pulliam, LMHC
Mental Health Counselor
NPI 1063787216
7700 NE 26TH AVE
Vancouver, WA 98665
(360) 397-8228
✔ PECOS✔ Accepts Medicare34 mi
David Taub
Clinical Social Worker
NPI 1942709134
7700 NE 26TH AVE
Vancouver, WA 98665
(360) 397-8228
✔ PECOS34 mi
Roxanne Weiner, LMHC
Mental Health Counselor
NPI 1710400619
7700 NE 26TH AVE
Vancouver, WA 98665
(360) 397-8228
✔ PECOS✔ Accepts Medicare34 mi
William Erickson, ANP
Nurse Practitioner
NPI 1205928652
7105 NE 40TH ST
Vancouver, WA 98661
(360) 933-3189
✔ PECOS✔ Accepts Medicare37 mi
Jessica Feinman, M.D.
Psychiatry
NPI 1528169331
7105 NE 40TH ST
Vancouver, WA 98661
(360) 933-3189
✔ PECOS✔ Accepts Medicare37 mi
Kevin Fischer, MD
Addiction Medicine
NPI 1184884082
7105 NE 40TH ST
Vancouver, WA 98661
(360) 933-3189
✔ PECOS37 mi
Sandra Baker, LICSW
Clinical Social Worker
NPI 1629561634
1000 DAVIS PL
Dupont, WA 98327
(360) 946-2498
✔ PECOS✔ Accepts Medicare69 mi
Maytal Grossman, LMFT
Marriage and Family Therapist
NPI 1598022584
15455 65TH AVE S
Tukwila, WA 98188
(206) 721-5170
✔ PECOS97 mi
See all 44 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cowlitz Indian Tribe's NPI number?

The NPI number for Cowlitz Indian Tribe is 1740562909. It was assigned to this organization in the NPPES registry on September 14, 2011. The provider is also known as Cowlitz Indian Tribal Health Services.

Where is Cowlitz Indian Tribe located?

Cowlitz Indian Tribe is located at 1044 11th Ave, Longview, WA 98632. The listed phone number is (360) 575-8275.

What is Cowlitz Indian Tribe's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Cowlitz Indian Tribe enrolled in Medicare?

Yes. Cowlitz Indian Tribe is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Cowlitz Indian Tribe?

According to the CMS Revalidation Reassignment List (October 2026 release), 44 clinicians in 9 Medicare specialties reassign their Medicare billing to Cowlitz Indian Tribe. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Mental Health Counselor (12), Clinical Social Worker (11) and Nurse Practitioner (11). Of these, 4 practice at this address and 10 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Cowlitz Indian Tribe was last updated on March 22, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.