Organization
PAKC DSL INC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH O HALLMAN MD (PRESIDENT)
(360) 792-6736
Entity
Organization
Contact information
Practice address
2520 CHERRY AVE, PATHOLOGY DEPT HARRISON MEDICAL CENTER, BREMERTON, WA 98310
(360) 744-6731
(360) 744-6561
Mailing address
PO BOX 2171, BREMERTON, WA 98310-0368
(360) 271-7274
(360) 479-7018
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 & INDUSTRIES
WA
05
—
7107287
—
WA
01
—
9109177600
KPS
WA
01
—
KI0446
REGENCE
WA
Enumeration date
12/26/2006
Last updated
04/27/2010
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