Organization
THE DOCTORS CLINIC A PROFESSIONAL CORPORATION
Active
Organization
THE DOCTORS CLINIC A PROFESSIONAL CORPORATION
Active
Other names
The Doctors Clinic a part of Franciscan Medical Group, THE DOCTORS CLINIC OF PORT ORCHARD
Organization subpart
No
Provider details
NPI number
Authorized official
JAY BURGHART (EXECUTIVE DIRECTOR)
(360) 782-3600
Entity
Organization
Contact information
Practice address
450 S KITSAP BLVD, BLDG. 1, SUITE 250, PORT ORCHARD, WA 98366-3773
(360) 782-3000
(360) 782-3040
Mailing address
9621 RIDGETOP BLVD NW, SILVERDALE, WA 98383-8502
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
337018600
OWCP
WA
01
—
50D0635293
CLIA
WA
05
—
7053895
—
WA
01
—
8919256
CRIME VICTIMS COMPENSATIO
WA
01
—
CU0247
RAILROAD MEDICARE
WA
Enumeration date
05/05/2006
Last updated
11/01/2019
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