Organization
PAKC DSL INC PS
Active
Other names
Pathology Associates of Kitsap County
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH O HALLMAN MD (VICE PRESIDENT)
(360) 744-6736
Entity
Organization
Contact information
Practice address
3261 NW MOUNT VINTAGE WAY, SUITE 301, SILVERDALE, WA 98383-6039
(360) 440-5630
(360) 440-5669
Mailing address
PO BOX 2171, BREMERTON, WA 98310-0368
(360) 440-5630
(360) 440-5669
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022905001
GROUP HEALTH
WA
01
—
154370
LABOR AND INDUSTRIES
—
01
—
9109177600
KPS
WA
01
—
KI0446
REGENCE
WA
Enumeration date
01/29/2011
Last updated
01/29/2011
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