EPAFARA JEFFREY VAITAUTOLU


Address: 30 Wencker Way Apt A, Bremerton, WA 98312-1861
Phone: 3604341434

EPAFARA JEFFREY VAITAUTOLU (NPI# 1598027237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1598027237
Entity Type Individual
Full Name EPAFARA JEFFREY VAITAUTOLU
Practice Address 30 Wencker Way Apt A
Bremerton
WA 98312-1861
Mailing Address Uss Nimitz
Cvn -68
Fpo
AP 96620-2820
Practice Telephone 3604341434
Mailing Telephone 3604341434
Enumeration Date 2012-06-08
Last Update Date 2012-06-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1002X Military Health Care Provider
Specialization: Independent Duty Corpsman
CA Other Service Providers

Office Location

Street Address 30 WENCKER WAY APT A
City BREMERTON
State WA
Zip Code 98312-1861

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Taxonomy Information

Taxonomy Code 1710I1002X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Corpsman

Taxonomy Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1083944409 Joseph Enderton Military Health Care Provider 3864 Chum Ln Nw, Bremerton, WA 98312-9443 2010-01-07
1982934303 Gordon John Bergman Military Health Care Provider 2821 Montwood Ln, Bremerton, WA 98312-1936 2010-01-07
1568633113 Stephen Zachary Taylor Military Health Care Provider 62c Haven Rd, Bremerton, WA 98312 2008-03-21
1487850137 Brian Albert Nielson Military Health Care Provider 1662 Northlake Way Nw, Bremerton, WA 98312-1716 2007-06-21
1013123405 James Jon Ruane Military Health Care Provider 6935 Liverpool Ct Ne, Bremerton, WA 98311-9646 2007-05-15
1548289069 Michael Nord Military Health Care Provider 7481 Bridlevale Blvd Nw, Bremerton, WA 98311-8987 2006-07-18
1295762862 Shane Ray Reece Military Health Care Provider 4068 Redwing Trail Nw, Bremerton, WA 98312 2006-06-27
1164459707 Steven Allen Bradsher Military Health Care Provider 3350 Narrows View Ln Ne, # 202, Bremerton, WA 98310-6605 2006-06-27
1669429213 Alan D Garrigus Military Health Care Provider Branch Health Clinic Psns, 1400 Farragu Ave, Bremerton, WA 98314-0001 2006-05-28
1770976094 Janne Lynne Wellborn Military Health Care Provider 1 Boone Rd, Bremerton, WA 98312 2015-03-11
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Competitor

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City BREMERTON
Zip Code 98312

Improve Information

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Dataset Information

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.

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