Organization · Type 2 NPI

Peacehealth

Urology Physician · Longview, WA

NPI number 1255977591 Active

Practice location

625 9th Ave Ste 120
Longview, WA 98632-2465

Call (360) 636-8950 Map

Fax (360) 636-8951

Mailing address

1115 SE 164th Ave Dept 358
Vancouver, WA 98683-8004

Specialties and licenses

Taxonomy	Code	License
Urology Physician Primary	208800000X	None listed
Durable Medical Equipment & Medical Supplies	332B00000X	None listed

Urology Physician: A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

6 other providers at this address

Other urology physician providers in Longview

Longview Urology PLLCUrology Physician Longview, WA NPI 1730187766

See all in Longview →

NPI record

NPI: 1255977591
Entity type: Organization (Type 2)
Issued: Nov 21, 2019
Last updated: Nov 27, 2019
Status: Active
Subpart: Yes of Peacehealth

Other names

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Peacehealth Longview Urology · doing business as
Peacehealth Longview Urology · doing business as

Authorized official

Michael Charles Metcalf
Chief Executive PHMG
(360) 729-1743

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1255977591

Peacehealth's National Provider Identifier is 1255977591, issued on Nov 21, 2019. The primary taxonomy on file is Urology Physician (208800000X), and the practice location is in Longview, WA. The record was last updated on Nov 27, 2019.