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Organization

UNITED STATES ARMY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY I BASS PSY.D. (RESIDENCY DIRECTOR OF TRAINING)
(808) 433-6340
Entity
Organization

Contact information

Practice address
1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, HI 96859-5001
(808) 433-6060
Mailing address
91-1030 KAILEOLEA DR, E3, EWA BEACH, HI 96706-6051
(806) 778-3897

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
563
WY

Other

Enumeration date
03/30/2015
Last updated
03/30/2015
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