PEACEHEALTH

Provider Demographics

• NPI: 1134178999
• Name: PEACEHEALTH
• Entity type: Organization
• Organization Name: PEACEHEALTH
• Other - Org Name: <UNAVAIL>
• Authorized Official - Title/Position: SYS VP FIN INTEGRITY/CONTROLLER
• Authorized Official - First Name: JEFFREY
• Authorized Official - Last Name: SEIRER
• Authorized Official - Phone: 360-729-1132
• Mailing Address - Street 1: 1115 SE 164TH AVE DEPT 328
• Mailing Address - City: VANCOUVER
• Mailing Address - State: WA
• Mailing Address - Zip Code: 98683-8003
• Mailing Address - Country: US
• Mailing Address - Phone: 360-729-1462
• Mailing Address - Fax: 360-729-3104
• Practice Address - Street 1: 400 NE MOTHER JOSEPH PL
• Practice Address - City: VANCOUVER
• Practice Address - State: WA
• Practice Address - Zip Code: 98664-3200
• Practice Address - Country: US
• Practice Address - Phone: 360-256-2000
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-05-09
• Last Update Date: 2025-01-23

Provider Licenses

State	License ID	Taxonomies
		251G00000X, 315D00000X
WA	H-170	273R00000X, 273Y00000X, 282N00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	282N00000X	Hospitals	General Acute Care Hospital
No	251G00000X	Agencies	Hospice Care, Community Based
No	273R00000X	Hospital Units	Psychiatric Unit
No	273Y00000X	Hospital Units	Rehabilitation Unit
No	315D00000X	Nursing & Custodial Care Facilities	Hospice, Inpatient

Provider Identifiers

State	Identifier ID	ID Type	Issuer
WA	3200292	Medicaid
WA	7013428	Medicaid
WA	7056765	Medicaid
WA	7300445	Medicaid
WA	7013436	Medicaid
WA	7064579	Medicaid
WA	9634890	Medicaid
WA	7099260	Medicaid
WA	3304409	Medicaid
WA	7014350	Medicaid
WA	7062193	Medicaid
WA	7070154	Medicaid
WA	7407844	Medicaid
WA	7034754	Medicaid
WA	7071954	Medicaid
WA	CQ2107	Medicare ID - Type Unspecified	MEDICARE RAILROAD
WA	3200292	Medicaid
WA	7407844	Medicaid
WA	7014350	Medicaid
WA	7062193	Medicaid