PEACEHEALTH (NPI# 1184106437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184106437 |
| Entity Type | Organization |
| Organization Name | PEACEHEALTH |
| Other Organization Name | ST. JOHN MEDICAL CENTER-PEACEHEALTH THERAPY AND WELLNESS |
| Practice Address |
Triangle Mall Suite 16 1015 Ocean Beach Hwy Longview WA 98632 |
| Mailing Address |
1115 Se 164th Ave Dept 358 Vancouver WA 98683-8004 |
| Practice Telephone | 3605013750 |
| Practice Fax Number | 3605013751 |
| Mailing Telephone | 3607291462 |
| Mailing Fax Number | 3607293104 |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2018-09-04 |
| Authorized Official Name | MICHAEL CHARLES METCALF (CHIEF EXECUTIVE PHMG) |
| Authorized Official Telephone | 3607291743 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | WA | Suppliers | |
| Y | 335E00000X | Prosthetic/Orthotic Supplier | WA | Suppliers |
| Other Name | Type Code |
|---|---|
| St. John Medical Center-PeaceHealth Therapy and Wellness | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255977591 | Peacehealth | Durable Medical Equipment & Medical Supplies | 625 9th Ave Ste 120, Longview, WA 98632-2465 | 2019-11-21 |
| 1669766457 | Peacehealth | General Acute Care Hospital | 787 Woodland Acres Ln, Eugene, OR 97402-9378 | 2011-06-09 |
| 1760427082 | Peacehealth | Home Health | 126 Washington St, Ketchikan, AK 99901-5930 | 2006-06-19 |
| 1912957986 | Peacehealth | Clinical Medical Laboratory | 123 International Way, Springfield, OR 97477-1047 | 2006-05-11 |
| 1083672273 | Peacehealth | Rehabilitation Unit | 809 E Chestnut St, Bellingham, WA 98225-5221 | 2006-05-04 |
| 1447217559 | Peacehealth | Hospice, Inpatient | 2800 Douglas Avenue, Bellingham, WA 98225 | 2006-05-01 |
| 1215918719 | Peacehealth | Hospice Care, Community Based | 2230 Kingwood Street, Florence, OR 97439-9470 | 2005-11-10 |
| 1225019011 | Peacehealth | Home Health | 2230 Kingwood St, Florence, OR 97439-9464 | 2005-11-08 |
| 1346237971 | Peacehealth | General Acute Care Hospital | 1255 Hilyard St, Eugene, OR 97401-3718 | 2005-09-29 |
| 1689677320 | Peacehealth | General Acute Care Hospital | 2901 Squalicum Pkwy, Bellingham, WA 98225-1851 | 2005-05-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PEACEHEALTH | 1115 Se 164th Avenue, Vancouver, WA 98683-9324 |
| Washington State Corporations | PEACEHEALTH | 1115 Se 164th Ave Dept. 302, Vancouver, WA 98683 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH | 1115 Se 164th Ave Dept 302, Vancouver, WA 98683 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH - COTTAGE GROVE | 1515 Village Dr, Cottage Grove, OR 97424 |
| Washington State Corporations | PEACEHEALTH ASC BELLINGHAM, LLC | 1115 Se 164th Ave, Dept 302, Vancouver, WA 98683-9324 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH COTTAGE GROVE COMMUNITY MEDICAL CENTER | 1515 Village Dr, Cottage Grove, OR 97424 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH COTTAGE GROVE COMMUNITY MEDICAL CENTER FOUNDATION | 1515 Village Dr, Cottage Grove, OR 97424 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH COTTAGE GROVE COMMUNITY MEDICAL CENTER SWING | 1515 Village Drive, Cottage Grove, OR 97424 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH HOSPITAL MEDICINE | 3333 Riverbend Dr, Springfield, OR 97477 |
| Oregon Corporations, Companies and Business Names | PEACEHEALTH LABORATORIES | 123 International Way, Springfield, OR 97477 |
| Street Address |
TRIANGLE MALL SUITE 16 1015 OCEAN BEACH HWY |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
| 1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
| 1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
| 1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
| 1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
| 1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
| 1568853885 | Kaaren Lilly Marie Spanski-dreffin | Counselor | 1105 D 15th Ave, 186, Longview, WA 98632 | 2015-02-09 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326290248 | Genesis Medical Group, LLC. | Prosthetic/Orthotic Supplier | 1338 Commerce Ave Ste D, Longview, WA 98632-3743 | 2008-10-22 |
| 1184822793 | Steven G Mccullough and David W Holt Orthotics & Prosthetics, LLC | Prosthetic/Orthotic Supplier | 422 N Green St, Longview, TX 75601-6458 | 2007-07-05 |
| 1447344296 | Ava Inc. | Prosthetic/Orthotic Supplier | 1113 Vandercook Way, Suite 120, Longview, WA 98632-4024 | 2006-10-03 |
| 1750323713 | Edgar De La Fuente | Prosthetic/Orthotic Supplier | 719 N. Second Street, Longview, TX 75601-5316 | 2006-06-12 |
| 1740720366 | Hanger Clinic | Prosthetic/Orthotic Supplier | 1516 Hudson St, Suite 105, Longview, WA 98632-3083 | 2017-03-01 |
| 1629379490 | Steven Glenn Mccullough | Prosthetic/Orthotic Supplier | 422 N Green St, Longview, TX 75601-6458 | 2010-11-10 |
| 1992934053 | Prosthetic-orthotic Associates of East Texas, Inc. | Prosthetic/Orthotic Supplier | 414 E Loop 281, Suite 20, Longview, TX 75605-7930 | 2009-07-10 |
| 1508048984 | East Texas Prosthetic-orthotic Care | Prosthetic/Orthotic Supplier | 812 N 4th St, Longview, TX 75601-5413 | 2007-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699317784 | Preferred Orthotic and Prosthetic Services, Inc | Prosthetic/Orthotic Supplier | 520 S Cowley St Ste 104, Spokane, WA 99202-1315 | 2019-10-10 |
| 1629532536 | Preferred Orthotic and Prosthetic Services Inc | Prosthetic/Orthotic Supplier | 1708 Yakima Ave Ste 60, Tacoma, WA 98405 | 2019-01-24 |
| 1063906295 | Wmc Inc | Prosthetic/Orthotic Supplier | 2600 3rd Ave Ste B, Seattle, WA 98121-1293 | 2018-06-20 |
| 1174934707 | Nw Magnum LLC | Prosthetic/Orthotic Supplier | 108 Central Way, Kirkland, WA 98033-6106 | 2014-05-16 |
| 1205100013 | Cadence Biomedical, Inc. | Prosthetic/Orthotic Supplier | 146 N Canal St Ste 100, Seattle, WA 98103-8652 | 2012-02-27 |
| 1174807853 | Dental Sleep Therapy of Walla Walla Pllc | Prosthetic/Orthotic Supplier | 213 S 2nd Ave, Walla Walla, WA 99362-3002 | 2011-09-29 |
| 1922396159 | Hair Options | Prosthetic/Orthotic Supplier | 7106 Greenwood Ave N, Seattle, WA 98103-5038 | 2011-07-21 |
| 1083902746 | Seattle Cancer Care Alliance | Prosthetic/Orthotic Supplier | 207 Pontius Ave N, Suite 101, Seattle, WA 98109-5650 | 2011-07-15 |
| 1457645426 | Rcm Enterprise, LLC | Prosthetic/Orthotic Supplier | 8526 Delphi Rd Sw, Olympia, WA 98512-9349 | 2011-06-07 |
| 1417255019 | Beauty N Kurves LLC | Prosthetic/Orthotic Supplier | 513 1st Ave W, Seattle, WA 98119-3925 | 2011-03-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.