Organization
PEACEHEALTH
Active
Other names
St John Medical Center - Outpatient Therapies
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS HAYWOOD (REGIONAL VP/CFO)
(360) 414-5797
Entity
Organization
Contact information
Practice address
852 COMMERCE AVE, LONGVIEW, WA 98632-2406
(360) 501-3750
(360) 501-3755
Mailing address
PO BOX 249, LONGVIEW, WA 98632-7154
(360) 414-2092
(360) 578-3367
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/22/2008
Last updated
07/29/2011
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