Organization
PENINSULA COMMUNITY HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JA-ANGEL DEWALT (BILLING SPECIALIST LEAD)
(360) 377-3776
Entity
Organization
Contact information
Practice address
4841 AUTO CENTER WAY STE 203, BREMERTON, WA 98312-4388
(360) 377-3776
Mailing address
PO BOX 960, BREMERTON, WA 98337-0212
(360) 377-3776
(360) 373-2096
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
04/23/2020
Last updated
04/23/2020
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