Organization
OLYMPIC PENINSULA KIDNEY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATRINA ARDEL RUSSELL RN, CNN (ADMINISTRATOR)
(206) 915-9502
Entity
Organization
Contact information
Practice address
2613 WHEATON WAY, BREMERTON, WA 98310-3373
(360) 479-5908
(360) 479-5787
Mailing address
2613 WHEATON WAY, BREMERTON, WA 98310-3373
(360) 479-5908
(360) 479-5787
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3999109
—
WA
Enumeration date
05/11/2006
Last updated
12/15/2009
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