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Organization

PENINSULA COMMUNITY HEALTH SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIBEL NEAONVER (CREDENTIALING SPECIALIST)
(360) 616-3138
Entity
Organization

Contact information

Practice address
11901 137TH AVE NW UNIT A, GIG HARBOR, WA 98329-6617
(360) 377-3776
(360) 373-2096
Mailing address
PO BOX 960, BREMERTON, WA 98337-0212
(360) 377-3776
(360) 373-2096

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
261QF0400X
Federally Qualified Health Center (FQHC)

Other

Enumeration date
08/09/2021
Last updated
09/16/2021
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