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
2400 PERRY AVE, BREMERTON, WA 98310-5139
(360) 377-3776
Mailing address
PO BOX 960, BREMERTON, WA 98337-0212
(360) 377-3776
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
07/26/2019
Last updated
07/26/2019
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