Healthcare Provider Details

I. General information

NPI: 1215150313
Provider Name (Legal Business Name): LOWER COLUMBIA HEAD & NECK ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 11TH AVE
LONGVIEW WA
98632-2072
US

IV. Provider business mailing address

820 11TH AVE
LONGVIEW WA
98632-2072
US

V. Phone/Fax

Practice location:
  • Phone: 360-423-0960
  • Fax: 360-423-8902
Mailing address:
  • Phone: 360-423-0960
  • Fax: 360-423-8902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD00022010
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberMD00022010
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License NumberMD00022010
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberMD00022010
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License NumberMD00022010
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberMD00022010
License Number StateWA
# 7
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberMD00022010
License Number StateWA

VIII. Authorized Official

Name: ALEXANDER P IEROKOMOS
Title or Position: PRESIDENT
Credential: MD
Phone: 360-423-0960