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Cowlitz Indian Tribe

Cowlitz Indian Tribe is a healthcare organization registered as Public Health & General Preventive Medicine Physician in Longview, WA, holding Type 2 (organization) NPI 1619194123 since 2007. The authorized official on file is Shavon Keller, Billing Supervisor.

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NPI 1619194123
Entity type Organization (Type 2)
Legal business name Cowlitz Indian Tribe
Other name <Unavail>
Parent organization Cowlitz Indian Tribe
Practice address 900 FIR ST, Longview, WA, 98632
Phone 3603539422
Enumeration date 2007-04-19
Last updated in NPPES 2024-10-31

Authorized official

Name Shavon Keller
Title Billing Supervisor
Phone 3603539431

Taxonomy & classification

Taxonomy code Specialty Primary License State
261QH0100X Health Service Clinic/Center Secondary
261QM0801X Mental Health Clinic/Center (Including Community Mental Health Center) Secondary
261QR0405X Substance Use Disorder Rehabilitation Clinic/Center Secondary
2083P0901X Public Health & General Preventive Medicine Physician Primary

Other identifiers

Identifier Type State Issuer
1981224 Medicaid WA
Copy-ready billing details
Provider: Cowlitz Indian Tribe
NPI: 1619194123
Taxonomy: 2083P0901X (Public Health & General Preventive Medicine Physician)
Address: 900 FIR ST, Longview, WA, 98632

Providers at this address

NPI Name Type Specialty Location
1720086424 Natalie East Individual Physical Therapist Longview, WA
1699773390 Suzanne Gerhart Individual Physical Therapist Longview, WA
1528285038 Cowlitz Indian Tribe Organization Substance Use Disorder Rehabilitation Clinic/Center Longview, WA
1568701530 Kristine Rister Individual Clinical Social Worker Longview, WA
1043681513 Angela Naillon Individual Marriage & Family Therapist Longview, WA
1952840944 Kelsey Gravelle Individual Clinical Social Worker Longview, WA
1285133876 Angela Mitchell Individual Addiction (Substance Use Disorder) Counselor Longview, WA
1194217976 Tyler Stockton Individual Addiction (Substance Use Disorder) Counselor Longview, WA

Verify this record

Cross-check NPI 1619194123 against the authoritative CMS record: view Cowlitz Indian Tribe on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

Who is the authorized official for Cowlitz Indian Tribe?
NPPES lists Shavon Keller (Billing Supervisor) as the authorized official for this organization.
What is the NPI number for Cowlitz Indian Tribe?
The NPI for Cowlitz Indian Tribe is 1619194123, a Type 2 (organization) record in the CMS NPPES registry.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2024-10-31.