Individual
DR. JEREMY S ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
1 BOONE RD, BREMERTON, WA 98312-1894
(360) 315-4412
Mailing address
1 BOONE RD, BREMERTON, WA 98312-1894
(360) 475-5115
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
688
NE
207Q00000X
Family Medicine Physician
Primary
688
NE
Other
Enumeration date
12/13/2006
Last updated
04/28/2023
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