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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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