Organization
JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2
Active
Other names
Sleep Medicine, Jefferson Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY L PORTER (REGISTRATION COORDINATOR)
(360) 385-2200
Entity
Organization
Contact information
Practice address
9833 POPLARS AVE NW STE 104, SILVERDALE, WA 98383-7675
(360) 698-0422
(360) 698-0463
Mailing address
834 SHERIDAN AVE, PORT TOWNSEND, WA 98368-2443
(360) 385-2200
(360) 379-2282
Taxonomy
Speciality
Code
Description
License number
State
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
3301900
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3301900
—
WA
Enumeration date
05/03/2007
Last updated
10/11/2007
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