PEACEHEALTH ST JOHN MEDICAL CENTER (NPI# 1205043296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205043296 |
| Entity Type | Organization |
| Organization Name | PEACEHEALTH ST JOHN MEDICAL CENTER |
| Practice Address |
1615 Delaware St Longview WA 98632-2310 |
| Practice Telephone | 3604147821 |
| Practice Fax Number | 3604147366 |
| Mailing Telephone | 3604147821 |
| Mailing Fax Number | 3604147366 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. KAREN COLLELL (REGIONAL DIRECTOR, PHARMACY SERVICE) |
| Authorized Official Telephone | 3604147821 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
HF00001014 | WA | Pharmacy Service Providers |
| Street Address |
1615 DELAWARE ST |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-2310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548264252 | Lan N Pham | Internal Medicine | 1615 Delaware St, Longview, WA 98632-2367 | 2005-06-09 |
| 1629681127 | Cole Taylor Dawson | Pharmacist | 1615 Delaware St, Longview, WA 98632-2367 | 2020-08-25 |
| 1760008908 | Tanya Neely | Registered Nurse | 1615 Delaware St, Longview, WA 98632-2367 | 2020-06-23 |
| 1376167254 | Gareth John Penta | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-06-05 |
| 1982227013 | Crystal Ann Florek | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-05-22 |
| 1194356600 | Tiffany Terry | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-02-03 |
| 1285274167 | Jason Loren Whitney | Nurse Practitioner | 1615 Delaware St, Longview, WA 98632-2367 | 2020-01-08 |
| 1851857676 | Garrett Michael Alan Harrison | Case Manager/Care Coordinator | 1615 Delaware St, Longview, WA 98632-2367 | 2019-02-17 |
| 1184192189 | Katie Johnson | Clinical Nurse Specialist | 1615 Delaware St, Longview, WA 98632-2367 | 2018-11-07 |
| 1750864187 | Brina Rayne Moh | Physician Assistant | 1615 Delaware St, Longview, WA 98632-2367 | 2018-09-11 |
| Find all providers in the same location | ||||
| 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 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 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 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881001907 | Amanda Schneider | Pharmacist | 3715 Ocean Beach Hwy, Longview, WA 98632-4801 | 2014-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912362070 | Ashley Johnson | Pharmacist | 734 Crestview Pl, Walla Walla, WA 99362-4230 | 2015-12-16 |
| 1649516436 | Andrew James Harbison | Pharmacist | 7080 Killeen Pl Sw, Port Orchard, WA 98367-7617 | 2012-12-24 |
| 1265627640 | Marilyn G Bufton | Pharmacist | 2107 Wilderness Ridge Rd, Bellingham, WA 98229-6901 | 2007-09-10 |
| 1386835817 | Julia Ann Barnett | Pharmacist | 16550 177th Ave Se, Po Box 777, Monroe, WA 98272 | 2007-08-08 |
| 1336356443 | Trent Lawrence Danielson | Pharmacist | 236 2nd Ave N., Okanogan, WA 98840 | 2007-05-17 |
| 1295858934 | Jeffrey B Purcell | Pharmacist | 325 9th Ave Box 359885, Seattle, WA 98104-2499 | 2007-04-09 |
| 1144340654 | Teri Lynn Gilbert | Pharmacist | 713 Canyon View Pl, Yakima, WA 98908-2105 | 2007-03-29 |
| 1386776995 | Edward O. Bye | Pharmacist | 16325 Thorpe Rd Ne, Poulsbo, WA 98370-8010 | 2007-03-09 |
| 1063554954 | Kyle Downey | Pharmacist | 6727 S Moran View St, Spokane, WA 99224-8494 | 2007-02-13 |
| 1447319918 | Steven Harold Erickson | Pharmacist | 24914 153rd Pl Se, Monroe, WA 98272-9558 | 2006-12-08 |
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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.