Peacehealth
May also be knows as Ketchikan Medical Center
Legal Business Name
Peacehealth
Also Known As
Ketchikan Medical Center
NPI Number
1801965736
NPI Type
Organization
Enumeration Date
11/07/2006
Specialties
(Taxonomies)Name
Code
207ZP0102X
207L00000X
207P00000X
207Q00000X
207R00000X
176B00000X
207V00000X
207X00000X
208000000X
Primary Taxonomy
No
No
No
No
No
No
No
No
No
Licenses
State
Alaska
License Number
NO NUMBERS ISSUED
Contact
Information
Purpose
Mailing
Location
Address
PO BOX 1798
3100 TONGASS AVE
City
Bellingham
Ketchikan
State
WA
AK
Postal Code
98227-1798
99901-5746
Country
US
US
Telephone Number
(360) 734-5400
(907) 228-8300
Authorized Official
Name
Patrick Branco
Title or Position
CEO
Telephone Number
(907) 228-8300
Identifiers
Identifier
6110165
7695464
MDG235
Identifier State
AK
AK
AK
Identifier Issuer
AETNA HOSPITAL PRO#
AETNA CLINIC PRO#
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 08/31/2011