Peacehealth St John Medical Center

Primary specialty

Pharmacotherapy PharmacistTaxonomy code 1835P1200X

License

HF00001014 Issued in WA

Legal business name

PEACEHEALTH ST JOHN MEDICAL CENTER

Practice address

1615 Delaware St
Longview, WA 98632-2310

Phone

(360) 414-7821

Fax

(360) 414-7366

NPI assigned

May 17, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Karen Collell

Title

Regional Director, Pharmacy Service

Phone

(360) 414-7821

Specialties & licenses 1

Addresses

Tax ID family

PH Behaviroal Health6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

• Peacehealth

  dba St. John Medical Center-PeaceHealth Therapy and Wellness

  • Prosthetic/Orthotic Supplier
  • Longview, WA
  • NPI 1184106437
  NPD tax ID
• Peacehealth

  dba PeaceHealth Longview Urology

  • Urology Physician
  • Longview, WA
  • NPI 1255977591
  NPD tax ID
• Peacehealth

  dba St. John Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Longview, WA
  • NPI 1639285539
  NPD tax ID
• Peacehealth

  dba St John Medical Center - PeaceHealth Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Longview, WA
  • NPI 1801909171
  NPD tax ID
• Peacehealth

  dba PeaceHealth St John Medical Center Pharmacy

  • Community/Retail Pharmacy
  • Longview, WA
  • NPI 1811252687
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205043296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 DELAWARE ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322310",
            "telephone_number": "360-414-7821",
            "fax_number": "360-414-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 DELAWARE ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322310",
            "telephone_number": "360-414-7821",
            "fax_number": "360-414-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEHEALTH ST JOHN MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COLLELL",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR, PHARMACY SERVICE",
        "authorized_official_telephone_number": "360-414-7821",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "WA",
            "license": "HF00001014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peacehealth (St John Medical Center - PeaceHealth Medical Group)
• Peacehealth (PeaceHealth St John Medical Center Pharmacy)
• Peacehealth (St John Medical Center - Internal Medicine)
• Peacehealth (St John Medical Center - PeaceHealth Medical Group Ocean Beach)
• Peacehealth (St John Medical Center - Outpatient Therapies)
• Tia Pearrow
• Diana Carole Pearson, BA
• Michael Pearson, AAC
• Pediatric Cardiology Center of Oregon PC
• Pediatric Clinic, Inc., P.S.

• Pharmacotherapy Pharmacist in Longview, WA
• Providers in Longview, WA by specialty
• Pharmacotherapy Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.