| Organization Name: | COWLITZ FAMILY HEALTH CENTER |
| NPI Number: | 1891856142 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DIAN COOPER (EXECUTIVE DIRECTOR) |
| Mailing Address: | 21610 Pacific Hwy Ocean Park |
| State: | WA US |
| Postal Code: | 98640 |
| Phone Number: | 3606653000 |
| Fax Number: | 3606653096 |
| NPI Enumeration Date: | 12/12/2006 |
| NPI Last Update Date: | 12/04/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |