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Contact Information

CONFEDERATED TRIBES OF COOS, LOWER UMPQUA & SIUSLAW INDIANS
150 S WALL ST
COOS BAY, OR97420-3233
 Phone: 541-435-7200
 Fax: 541-888-0025
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Primary Care

261QP2300X
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Community Health

261QC1500X
 

Community/Behavioral Health

251S00000X
 

Dental Therapist

125J00000X
 

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
 

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

332800000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for CONFEDERATED TRIBES OF COOS, LOWER UMPQUA & SIUSLAW INDIANS

NPI # 1780755454
LBN Legal business name CONFEDERATED TRIBES OF COOS, LOWER UMPQUA & SIUSLAW INDIANS
Authorized official DAVON SMITH - (CHIEF OPERATIONS OFFICER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/13/2006
Last updated 04/13/2026 - About 2 months ago
Identifiers
OR Medicaid 165383
OR Medicaid 500838955
OR Other RP-0003971-CS OREGON BOARD OF PHARMACY - CONTROLLED SUBSTANCE
OR Other RP-0003971 OREGON BOARD OF PHARMACY - RETAIL DRUG OUTLET
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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