Individual
DWIGHT GARY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1 BOONE RD, BREMERTON, WA 98312-1894
(860) 405-5732
Mailing address
1946 SE LARCH LN APT 6-01, PORT ORCHARD, WA 98366-6014
(860) 405-5732
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
818024
NY
Other
Enumeration date
08/12/2021
Last updated
08/12/2021
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