Organization
JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2
Active
Other names
JEFFERSON UROLOGY CLINIC, Jefferson Healthcare Urology Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE GLENN (CEO)
(360) 385-2200
Entity
Organization
Contact information
Practice address
1274 7TH ST STE B, PORT TOWNSEND, WA 98368-2404
(360) 385-2905
(360) 385-6796
Mailing address
834 SHERIDAN ST, PORT TOWNSEND, WA 98368-2443
(360) 385-2200
(360) 379-2256
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
HAC.FS.00000085
WA
Other
Enumeration date
03/27/2015
Last updated
10/29/2020
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