MEDICARE: PEACEHEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	NO NUMBER ASSIGNED	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760427082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACEHEALTH

Provider Business Mailing Address
First Line	:	1115 SE 164TH AVE DEPT 328
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98683-8003
Country	:	US
Telephone Number	:	360-729-1462
Fax Number	:	360-729-3104

Provider Business Practice Location Address
First Line	:	212 CARLANNA LAKE RD STE 100
Second Line	:
City	:	KETCHIKAN
State	:	AK
Zip	:	99901-5642
Country	:	US
Telephone Number	:	907-225-8914
Fax Number	:

Authorized Official
Title or Position	:	SYS VP FIN INTEGRITY/CONTROLLER
Name	:	ARTHUR CRAIG SPRINGER II
Credential	:
Telephone Number	:	360-729-1132

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	04/16/2026

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1992042790 — DR. ERIC MATTHEW BURKE PHARMD
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Directions to “PEACEHEALTH ” Practice Location

Language	Start Address	Practice Location

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