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General NPI Number Information
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NPI Number | 1558015057
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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 | 02/04/2022
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 5400 MACARTHUR BLVD
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City | VANCOUVER
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State | WA
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Zip | 98661-7049
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Country | US
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Telephone | 360-696-5100
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Fax | 360-696-5038
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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 | SYS VP FIN INTEGRIT/CONTROLLER
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Name | JEFFREY SEIRER
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Credential |
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Telephone | 360-729-1132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 315D00000X
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Taxonomy Name | Inpatient Hospice
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License Number |
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License Number State |
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