Organization
PEACEHEALTH
Active
Other names
PeaceHealth Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DARRIN MITCHELL MONTALVO (EVP CHIEF FINANCIAL /GROWTH OFFICER)
(360) 729-1102
Entity
Organization
Contact information
Practice address
2901 SQUALICUM PKWY, BELLINGHAM, WA 98225-1851
(360) 734-5400
(360) 756-6830
Mailing address
1115 SE 164TH AVE DEPT 358, VANCOUVER, WA 98683-8004
(360) 729-2150
(541) 431-8213
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
208M00000X
Hospitalist Physician
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7010440
—
WA
05
—
7098361
—
WA
Enumeration date
05/04/2006
Last updated
11/30/2020
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