Organization
PENINSULA COMMUNITY HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER KREIDLER-MOSS (CEO)
(360) 475-6707
Entity
Organization
Contact information
Practice address
5455 ALMIRA DR NE, BREMERTON, WA 98311-8330
(360) 377-3776
Mailing address
PO BOX 960, BREMERTON, WA 98337-0212
(360) 377-3776
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
251E00000X
Home Health Agency
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
WA
Enumeration date
11/13/2015
Last updated
05/10/2022
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