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General NPI Number Information
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NPI Number | 1144664954
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Entity Type | Organization
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Legal Business Name | PEACEHEALTH
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Dates
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Enumeration Date | 04/23/2013
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 2000 HOSPITAL DR
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City | SEDRO WOOLLEY
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State | WA
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Zip | 98284-4327
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Country | US
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Telephone | 360-788-7768
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Fax | 360-714-2508
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Provider Business Mailing Address
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Address Line | 1115 SE 164TH AVE DEPT 328
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City | VANCOUVER
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State | WA
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Zip | 98683-8003
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Country | US
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Telephone | 360-729-1462
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Fax | 360-729-3104
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Authorized Official
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Title or Position | EVP CHIEF FINANCIAL /GROWTH OFFICER
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Name | DARRIN MONTALVO
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Credential |
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Telephone | 360-729-1102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | HAC.FS.60417818
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License Number State | WA
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