Organization
PEACEHEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY SEIRER (SYS VP FIN INTEGRIT/CONTROLLER)
(360) 729-1132
Entity
Organization
Contact information
Practice address
700 LINCOLN ST STE 100, KELSO, WA 98626-1062
(360) 425-5131
(360) 425-5509
Mailing address
1115 SE 164TH AVE DEPT 358, VANCOUVER, WA 98683-8004
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
12/07/2022
Last updated
12/07/2022
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