Organization
PENINSULA COMMUNITY HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JA-ANGEL DEWALT (REVENUE CYCLE MANAGER)
(360) 475-6711
Entity
Organization
Contact information
Practice address
3100 NW BUCKLIN HILL RD STE 202, SILVERDALE, WA 98383-8362
(360) 377-3776
Mailing address
PO BOX 960, BREMERTON, WA 98337-0212
(360) 377-3776
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
07/02/2019
Last updated
04/28/2020
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