Peacehealth

NPI #1235556846 in Ketchikan, Alaska

Provider Information

NPI Number: 1235556846
Entity Type: Organization
Organization Name: Peacehealth
Primary Specialty: Surgery
Enumeration Date: Mar 20, 2014
Last Updated: Mar 20, 2014

Practice Location

Address: 212 CARLANNA LAKE RD
Address 2: #204
City: Ketchikan
State: Alaska
ZIP Code: 99901-5642
Phone: (907) 225-7346

Authorized Official

Name: LORI MCCOY
Title: PROVIDER ENROLLMENT SPECIALIST
Phone: (360) 729-1411

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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