Organization
PEACEHEALTH
Active
Other names
St John Medical Center - PeaceHealth Medical Group Castle Rock
Organization subpart
No
Provider details
NPI number
Authorized official
TOM HAYWOOD (REGIONAL CFO)
(360) 414-2000
Entity
Organization
Contact information
Practice address
139 1ST AVE SW, CASTLE ROCK, WA 98611
(360) 274-2353
(360) 274-2354
Mailing address
PO BOX 160, CASTLE ROCK, WA 98611-0160
(360) 274-2353
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/04/2010
Last updated
07/29/2011
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