Organization
PENINSULA COMMUNITY HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL P EMERY (CFO)
(360) 475-6710
Entity
Organization
Contact information
Practice address
616 6TH ST, BREMERTON, WA 98337-1420
(360) 377-3776
(360) 479-0038
Mailing address
PO BOX 960, BREMERTON, WA 98337-0212
(360) 478-2366
(360) 373-2096
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
122300000X
Dentist
—
—
124Q00000X
Dental Hygienist
—
—
133N00000X
Nutritionist
—
—
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
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7069461
—
WA
01
—
CF9820
RAILROAD MEDICARE
—
Enumeration date
05/11/2006
Last updated
04/10/2020
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