Individual
PAUL TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2520 CHERRY AVE, BREMERTON, WA 98310-4229
(360) 377-3911
(360) 792-6889
Mailing address
2520 CHERRY AVE, BREMERTON, WA 98310-4229
(360) 377-2349
(360) 377-2263
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD00013450
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8291205
—
WA
Enumeration date
07/12/2006
Last updated
05/16/2008
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