PENINSULA COMMUNITY HEALTH SERVICES (NPI# 1053950832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053950832 |
| Entity Type | Organization |
| Organization Name | PENINSULA COMMUNITY HEALTH SERVICES |
| Practice Address |
320 S Kitsap Blvd Port Orchard WA 98366-3778 |
| Mailing Address |
Po Box 960 Bremerton WA 98337-0212 |
| Practice Telephone | 3603773776 |
| Mailing Telephone | 3603773776 |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2020-01-02 |
| Authorized Official Name | JA-ANGEL DEWALT (BILLING LEAD) |
| Authorized Official Telephone | 3603773776 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 103TF0000X |
Psychologist Specialization: Family |
Behavioral Health & Social Service Providers | ||
| N | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
Behavioral Health & Social Service Providers | ||
| N | 103TP0814X |
Psychologist Specialization: Psychoanalysis |
Behavioral Health & Social Service Providers | ||
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2508 Wheaton Way, Bremerton, WA 983103303 | 3603773776 | |
| 616 6th St, Bremerton, WA 983371420 | 3603773776 | |
| 2442 Perry Ave, Bremerton, WA 983105139 | 3603773776 | |
| 8107 Central Valley Rd Ne, Bremerton, WA 983119155 | 3603773776 | |
| 2650 Ne John Carlson Rd, Bremerton, WA 983113928 | 3603773776 | |
| 5455 Almira Dr Ne, Bremerton, WA 983118330 | 3603773776 | |
| 300 E Campus Dr, Belfair, WA 985288307 | 3603773776 | |
| 31 Ne State Route 300 Ste 200, Belfair, WA 985288668 | 3603773776 | |
| 25989 Barber Cut Off Rd Ne, Kingston, WA 983468455 | 3603773776 | |
| 627 W Franklin St, Shelton, WA 985843504 | 3603773776 | |
| 19917 7th Ave Ne Ste 205, Poulsbo, WA 983706555 | 3603773776 | |
| 3100 Nw Bucklin Hill Rd Ste 226, Silverdale, WA 983838364 | 3603773776 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235759879 | Peninsula Community Health Services | Counselor | 4841 Auto Center Way Ste 203, Bremerton, WA 98312-4388 | 2020-04-23 |
| 1356995534 | Peninsula Community Health Services | Counselor | 2650 Ne John Carlson Rd, Bremerton, WA 98311-3928 | 2019-07-26 |
| 1407400682 | Peninsula Community Health Services | Counselor | 8107 Central Valley Rd Ne, Bremerton, WA 98311-9155 | 2019-07-26 |
| 1942861000 | Peninsula Community Health Services | Counselor | 3100 Nw Bucklin Hill Rd Ste 202, Silverdale, WA 98383-8362 | 2019-06-27 |
| 1770062242 | Peninsula Community Health Services | Clinic/Center | 300 E Campus Dr, Belfair, WA 98528-8307 | 2018-08-07 |
| 1528547940 | Peninsula Community Health Services | Dentist | 19705 Viking Avenue Nw, Suite 201 Bldg A, Poulsbo, WA 98370-8351 | 2018-08-07 |
| 1528517216 | Peninsula Community Health Services | Family Medicine | 31 Ne State Route 300, Suite 200, Belfair, WA 98528-8611 | 2016-09-23 |
| 1760617997 | Peninsula Community Health Services | Pharmacy | 19917 7th Ave Ne Ste 205, Suite 205, Poulsbo, WA 98370-6555 | 2009-05-18 |
| 1457990509 | Peninsula Community Health Services | Clinic/Center | 616 6th St, Bremerton, WA 98337-1420 | 2020-01-06 |
| 1972157139 | Peninsula Community Health Services | Counselor | 2400 Perry Ave, Bremerton, WA 98310-5139 | 2019-07-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PENINSULA COMMUNITY HEALTH SERVICES | 400 Warren Ave Suite 200, Bremerton, WA 98337-1467 |
| System for Award Management (SAM) Entities | PENINSULA COMMUNITY HEALTH SERVICES OF ALASKA, INC. | 230 E Marydale Ave Ste 3, Soldotna, AK 99669-7648 |
| Street Address |
320 S KITSAP BLVD |
| City | PORT ORCHARD |
| State | WA |
| Zip Code | 98366-3778 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982695128 | Regina B Bonnevie-rogers | Internal Medicine | 320 S Kitsap Blvd, Port Orchard, WA 98366-3778 | 2005-11-04 |
| 1669981510 | Doddie A Lagervall | Counselor | 320 S Kitsap Blvd, Port Orchard, WA 98366-3778 | 2017-09-22 |
| 1942660592 | Holly Wolfe | Dietitian, Registered | 320 S Kitsap Blvd, Port Orchard, WA 98366-3778 | 2016-02-24 |
| 1881050029 | Margaret Lowe | Nurse Practitioner | 320 S Kitsap Blvd, Port Orchard, WA 98366-3778 | 2016-01-04 |
| 1427303171 | Deborah Christine Olin | Counselor | 320 S Kitsap Blvd, Port Orchard, WA 98366-3778 | 2012-07-18 |
| 1346504735 | Colleen C Williams | Nurse Practitioner | 320 S Kitsap Blvd, Port Orchard, WA 98366-3778 | 2012-06-29 |
| 1881850998 | Michelle Jahn | Counselor | 320 S Kitsap Blvd, Port Orchard, WA 98366-3778 | 2008-07-29 |
| 1679665483 | Peninsula Community Health Servicess | Pharmacy | 320 S Kitsap Blvd, Port Orchard, WA 98366 | 2006-09-29 |
| 1386749281 | Clement Phuong Nguyen Le Thanh | Pediatrics | 320 S Kitsap Blvd, Port Orchard, WA 98366 | 2006-09-14 |
| 1225143670 | Ann Bridges Bruce | Psychiatry & Neurology | 320 S Kitsap Blvd, Port Orchard, WA 98366-3778 | 2006-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003423302 | Teresa M Derouin | Speech-Language Pathologist | Harbor Speech Pathology, 463 Tremont St W Suite 110, Port Orchard, WA 98366 | 2020-09-30 |
| 1316591217 | Martin Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 8079 E Main Street, Suite 101, Port Orchard, WA 98366 | 2019-07-29 |
| 1952822660 | Kristian Thomas Workman Haskins | Hearing Instrument Specialist | 1328 Colchester Drive S.e., Port Orchard, WA 98366 | 2017-07-03 |
| 1013466929 | Jenna Olafson | Counselor | 414 Front St. N, Issaquah, WA 98366 | 2016-10-04 |
| 1063884534 | Laurine Burrer | Licensed Practical Nurse | 2874 Se Lund Ave, Port Orchard, WA 98366 | 2015-10-23 |
| 1346640836 | Karen Diane Thompson | Pharmacy Technician | 1800 Sidney Ave, Apt 1-201, Port Orchard, WA 98366 | 2014-09-03 |
| 1588912042 | Celeste Kyle Interrante | Physical Therapy Assistant | 2051 Pottery Ave., Port Orchard, WA 98366 | 2012-08-15 |
| 1013227339 | Christine Davis | Massage Therapist | 1800 Se Mile Hill Drive, Suite 150, Port Orchard, WA 98366 | 2010-10-20 |
| 1932421724 | Mary Jo Stump | Physical Therapy Assistant | 2051 Pottery Avenue, Port Orchard, WA 98366 | 2010-02-19 |
| 1669707626 | Shannon Mary Baurichter | Speech-Language Pathologist | 1230 Bay St, Port Orchard, WA 98366 | 2009-10-08 |
| Find all providers in zip 98366 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447869342 | Unity Care Northwest | Clinic/Center | 6046 Portal Way Ste 202, Ferndale, WA 98248-7829 | 2020-07-27 |
| 1881219426 | Healthpoint | Clinic/Center | 2902 Ne 12th St Ste 102, Renton, WA 98056-3126 | 2020-06-09 |
| 1235778812 | Seattle Indian Health Board | Clinic/Center | 410 2nd Avenue Ext S, Seattle, WA 98104-2876 | 2019-12-31 |
| 1376185694 | Neighborcare Health | Clinic/Center | 2709 3rd Ave, Seattle, WA 98121-1217 | 2019-10-09 |
| 1295383958 | King County Finance | Clinic/Center | 908 Jefferson St Fl 11, Seattle, WA 98104-2433 | 2019-08-27 |
| 1063069839 | Sea-mar Community Health Center | Clinic/Center | 6004 Capitol Boulevard Southwest, Tumwater, WA 98501-8520 | 2019-08-26 |
| 1194379354 | Yakima Neighborhood Health Services | Clinic/Center | 201 S 6th St, Yakima, WA 98901-2928 | 2019-07-26 |
| 1881254449 | Neighborcare Health | Clinic/Center | 7101 62nd Ave Ne Ste 4, Seattle, WA 98115-7168 | 2019-06-17 |
| 1578028866 | Neighborcare Health | Clinic/Center | 2119 3rd Ave, Seattle, WA 98121-2333 | 2019-01-31 |
| 1144703885 | Healthpoint | Clinic/Center | 219 State Ave N, Ste 100, Kent, WA 98030 | 2018-09-10 |
| Find all providers with the same taxonomy | ||||
| City | PORT ORCHARD |
| Zip Code | 98366 |
Please comment or provide details below to improve the information on PENINSULA COMMUNITY HEALTH SERVICES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.