Organization
PEACEHEALTH
Active
Organization
PEACEHEALTH
Active
Other names
St. John Medical Center-PeaceHealth Therapy and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL CHARLES METCALF (CHIEF EXECUTIVE PHMG)
(360) 729-1743
Entity
Organization
Contact information
Practice address
TRIANGLE MALL SUITE 16 1015 OCEAN BEACH HWY, LONGVIEW, WA 98632
(360) 501-3750
(360) 501-3751
Mailing address
1115 SE 164TH AVE DEPT 358, VANCOUVER, WA 98683-8004
(360) 729-1462
(360) 729-3104
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
WA
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
WA
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up