Individual
DANA SHAY THERKILDSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDC
Contact information
Practice address
1 BOONE RD, BREMERTON, WA 98312-1894
(360) 475-4887
(360) 475-4522
Mailing address
USS JOHN C STENNIS CVN74, PO BOX 67, FPO, AP 96615
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710I1002X
INDEPENDENT DUTY CORPSMAN
—
Enumeration date
03/01/2007
Last updated
11/14/2013
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