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  5. COWLITZ FAMILY HEALTH CENTER

COWLITZ FAMILY HEALTH CENTER

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Company Details

Legal Name: COWLITZ FAMILY HEALTH CENTER
Jurisdiction: WASHINGTON
Entity Type: WA NONPROFIT CORPORATION
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: March 26th 1973
Expiration date: 31 Mar 2026
UBI Number: 600 176 084
FEIN Number: 91-0896241
Purpose: TO PROVIDE COMPREHENSIVE HEALTH SERVICES TO ALL IN NEED.
ZIP code: 98632
City: Longview
County: COWLITZ
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 1057 12TH AVE, LONGVIEW, WA, 98632-2509, UNITED STATES
Supporting healthcare providers fighting with COVID-19: $1,288,073

Contact Details

E-Mail: JCOFFEE@CFAMHC.ORG
Website: www.cowlitzfamilyhealth.org
Phone Number: +1 360-353-5803
+1 360-636-3892

Nature of Business

Charitable, HEALTHCARE SERVICES

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Registered Agent Information

Name Role Address
JIM COFFEE Registered Agent 1057 12TH AVE, LONGVIEW, WA, 98632-2509, UNITED STATES

Key Officers & Management

Name Role Address
RYLEIGH LEATHERWOOD Governing Person -
SANDRA BENBROOK-RIEDER Governing Person -
MARK NELSON Governing Person -
WANDA MCBEE Governing Person -
CYNTHIA WASHINGTON MATTSON Governing Person -
SANDI BENBROOK TREASURER 1057 12TH AVE, LONGVIEW, WA, 98632-2509, UNITED STATES
WANDA MCBEE SECRETARY 1057 12TH AVE, LONGVIEW, WA, 98632-2509, UNITED STATES
MARK NELSON PRESIDENT 1057 12TH AVE, LONGVIEW, WA, 98632-2509, UNITED STATES
CYNTHIA WASHINGTON-MATTSON VICE PRESIDENT 1057 12TH AVE, LONGVIEW, WA, 98632-2509, UNITED STATES
JAMES COFFEE CEO 1057 12TH AVE, LONGVIEW, WA, 98632-2509, UNITED STATES

Unique Entity ID

Unique Entity ID:
K2C9N2M49CP7
CAGE Code:
3QQR5
UEI Expiration Date:
2026-05-12

Business Information

URL:
http://cowlitzfamilyhealth.org/
Activation Date:
2025-05-14
Initial Registration Date:
2004-02-05

Commercial and government entity program

CAGE number:
3QQR5
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2025-05-14
CAGE Expiration:
2030-05-14
SAM Expiration:
2026-05-12
CAGE Link:
View company profile on CAGE website

Contact Information

POC:
JIM COFFEE
Corporate URL:
http://cowlitzfamilyhealth.org/

National Provider Identifier

NPI Number:
1609524164
Certification Date:
2022-10-18
Link:
View on NPI website

Authorized Person:

Name:
JAMES K COFFEE
Role:
CEO
Phone:
3603535803

Taxonomy:

Selected Taxonomy:
261QF0050X - Non-Surgical Family Planning Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QM0850X - Adult Mental Health Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QM0855X - Adolescent and Children Mental Health Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QF0400X - Federally Qualified Health Center (FQHC)
Is Primary:
Yes

Contacts:

Phone:
+1 360-261-7848
Fax:
3602328400
Phone:
+1 360-998-2357
Fax:
3609982887

Form 5500 Series

Employer Identification Number (EIN):
910896241
Plan Year:
2013
Number Of Participants:
63
Plan Name:
RETIREMENT PLAN
Sponsor's telephone number:
3606363892
File:
View File
Plan Administrator / Signatory:
DIAN COOPER(Plan administrator)
Plan Year:
2012
Number Of Participants:
66
Plan Name:
RETIREMENT PLAN
Sponsor's telephone number:
3606363892
File:
View File
Plan Administrator / Signatory:
DIAN COOPER(Plan administrator)
Plan Year:
2011
Number Of Participants:
63
Plan Name:
RETIREMENT PLAN
Sponsor's telephone number:
3606363892
File:
View File
Plan Administrator / Signatory:
ANDREA TRENNER(Plan administrator)
Plan Year:
2010
Number Of Participants:
49
Plan Name:
RETIREMENT PLAN
Sponsor's telephone number:
3606363892
File:
View File
Plan Administrator / Signatory:
ANDREA TRENNER(Plan administrator)
Plan Year:
2009
Number Of Participants:
0
Plan Name:
RETIREMENT PLAN
Sponsor's telephone number:
3606363892
File:
View File
Plan Administrator / Signatory:
NORMAN KRAFT(Plan administrator) NORMAN KRAFT(Employer/plan sponsor)

Tax Exempt

Employer Identification Number (EIN):
91-0896241
Ruling Date:
1974-01
Deductibility:
Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns

Return Type:
990
Tax Period:
202212
Link:
Download 990
Return Type:
990
Tax Period:
202112
Link:
Download 990
Return Type:
990
Tax Period:
201912
Link:
Download 990

Facilities

FRS ID:
110049981819
Facility Address:
COWLITZ, WA
Link:
View a detailed facility report on Enforcement and Compliance History (ECHO)

Labor Condition Applications

Case Number:
I-200-12187-316420
Program:
H-1B
Job Title:
INTERNAL MEDICINE PHYSICIAN
SOC (ONET/OES) code:
29-1063
SOC (ONET/OES) occupation title:
Internists, General
Begin Date:
2012-07-30
End Date:
2015-06-21

Employment and Wage Information

Address:
LONGVIEW, WA
Wage Rate Paid to Nonimmigrant Workers:
$76.92
Per:
Hour
Prevailing Wage Rate:
$64.82
Case Number:
I-200-09254-724231
Program:
H-1B
Job Title:
FAMILY PRACTITIONER
SOC (ONET/OES) code:
29-1062.00
SOC (ONET/OES) occupation title:
Family and General Practitioners
Begin Date:
2009-11-18
End Date:
2012-11-17

Employment and Wage Information

Address:
WOODLAND, WA
Wage Rate Paid to Nonimmigrant Workers:
$141,045
Per:
Year
Prevailing Wage Rate:
$141,045
Case Number:
I-08238-4456719
Program:
H-1B
Job Title:
GENERAL INTERNIST
SOC (ONET/OES) occupation title:
PHYSICIANS AND SURGEONS
Begin Date:
2008-09-02
End Date:
2011-09-01

Employment and Wage Information

Address:
Longview, WA
Wage Rate Paid to Nonimmigrant Workers:
$140,213
Per:
yr
Prevailing Wage Rate:
$120,536

Charity/Fundraiser/Trust

Registration Number:
1101172
Type:
CHARITABLE ORGANIZATION
Status:
Active
Renewal Date:
2025-11-30

Financial History

Fiscal Begin Date:
2023-01-01
Fiscal End Date:
2023-12-31
Begin Assets:
$25,271,330.00
Revenue:
$20,981,602.00
Program Services:
$19,907,005.00
Expenses:
$25,920,187.00
End Assets:
$21,664,125.00
% To Program Services:
77%
Fiscal Begin Date:
2022-01-01
Fiscal End Date:
2022-12-31
Begin Assets:
$20,747,034.00
Revenue:
$19,881,575.00
Program Services:
$19,881,575.00
Expenses:
$25,123,082.00
End Assets:
$25,271,330.00
% To Program Services:
79%
Fiscal Begin Date:
2021-01-01
Fiscal End Date:
2021-12-31
Begin Assets:
$21,415,629.00
Revenue:
$22,567,578.00
Program Services:
$18,059,104.00
Expenses:
$23,655,176.00
End Assets:
$20,747,034.00
% To Program Services:
76%
Fiscal Begin Date:
2020-01-01
Fiscal End Date:
2020-12-31
Begin Assets:
$22,417,472.00
Revenue:
$22,531,181.00
Program Services:
$18,539,316.00
Expenses:
$23,135,061.00
End Assets:
$21,415,629.00
% To Program Services:
80%
Fiscal Begin Date:
2019-01-01
Fiscal End Date:
2019-12-31
Begin Assets:
$22,788,434.00
Revenue:
$22,761,706.00
Program Services:
$18,962,502.00
Expenses:
$23,468,102.00
End Assets:
$22,417,472.00
% To Program Services:
81%

Related by address

1057 12TH AVE, LONGVIEW, WA, 98632-2509, UNITED STATES

DANIEL S. HAGHIGHI, D.D.S., P.S.
WA PROFESSIONAL SERVICE CORPORATION - Administratively Dissolved
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