Organization
PEACEHEALTH
Active
Parent organization
PEACEHEALTH
Other names
PeaceHealth Longview Urology
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEACEHEALTH
Authorized official
MICHAEL CHARLES METCALF (CHIEF EXECUTIVE PHMG)
(360) 729-1743
Entity
Organization
Contact information
Practice address
625 9TH AVE STE 120, LONGVIEW, WA 98632-2465
(360) 636-8950
(360) 636-8951
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
208800000X
Urology Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
11/21/2019
Last updated
11/27/2019
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