Cowlitz Indian Tribe – Substance Use Disorder Rehabilitation Clinic/Center, NPI 1538412630
Substance Use Disorder Rehabilitation Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Cowlitz Indian Tribe
15455 65TH AVE S
TUKWILA, WA 98188
Phone: (206) 721-5170
Fax: (206) 721-6288
Type: Location
PO BOX 2429
LONGVIEW, WA 986328486
Phone: (206) 721-5170
Fax: (206) 721-6288
Type: Mailing
7105 NE 40TH ST
VANCOUVER, WA 986613058
Phone: (360) 353-9431
Fax: (360) 353-9440
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-07-31 (315 days ago).
Enrollment records
1
Earliest due date
2025-07-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20050526000589 | O | Clinic/Group Practice | TX | 2025-07-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98188)
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