Individual
STANFORD CALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
5455 ALMIRA DR NE, BREMERTON, WA 98311-8330
(360) 373-5031
(360) 377-0458
Mailing address
555 PACIFIC AVE STE 202, GROUP HEALTH BREMERTON BEHAVIORAL HLTH, BREMERTON, WA 98337-1903
(509) 241-7205
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60423419
WA
Other
Enumeration date
11/06/2013
Last updated
11/16/2015
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