PENINSULA COMMUNITY HEALTH SERVICES (NPI# 1740630128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740630128 |
| Entity Type | Organization |
| Organization Name | PENINSULA COMMUNITY HEALTH SERVICES |
| Other Organization Name | PCHS DENTAL 6TH |
| Practice Address |
616 6th St Bremerton WA 98337-1420 |
| Mailing Address |
Po Box 960 Bremerton WA 98337-0212 |
| Practice Telephone | 3603773776 |
| Practice Fax Number | 3604790038 |
| Mailing Telephone | 3603773776 |
| Mailing Fax Number | 3604790038 |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2019-04-30 |
| Authorized Official Name | JENNIFER KREIDLER-MOSS (CEO) |
| Authorized Official Telephone | 3603773776 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | NPI | 05 |
| Other Name | Type Code |
|---|---|
| PCHS Dental 6th | Other Name - Individual/Organization |
| 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 |
| 1053950832 | Peninsula Community Health Services | Nurse Practitioner | 320 S Kitsap Blvd, Port Orchard, WA 98366-3778 | 2019-12-27 |
| 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 |
616 6TH ST |
| City | BREMERTON |
| State | WA |
| Zip Code | 98337-1420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861483109 | Arthur Douglas Felts | Family Medicine | 616 6th St, Bremerton, WA 98337-1420 | 2005-11-04 |
| 1255952701 | Emily Grace Conway | Nurse Practitioner | 616 6th St, Bremerton, WA 98337-1420 | 2020-05-06 |
| 1457990509 | Peninsula Community Health Services | Clinic/Center | 616 6th St, Bremerton, WA 98337-1420 | 2020-01-06 |
| 1629628649 | William Tatlonghari | Student in an Organized Health Care Education/Training Program | 616 6th St, Bremerton, WA 98337-1420 | 2019-09-12 |
| 1891257747 | Andrew Charles Lane | Dentist | 616 6th St, Bremerton, WA 98337-1420 | 2019-04-01 |
| 1992278030 | Peninsula Community Health Services | Clinic/Center | 616 6th St, Bremerton, WA 98337-1420 | 2019-01-10 |
| 1083187124 | Peninsula Community Health Services | Family Medicine | 616 6th St, Bremerton, WA 98337-1420 | 2019-01-10 |
| 1053823047 | Scott Jeffrey Clemons | Nurse Practitioner | 616 6th St, Bremerton, WA 98337-1420 | 2017-10-30 |
| 1891235388 | Edwin Gi Lim Kim | Dentist | 616 6th St, Bremerton, WA 98337-1420 | 2017-03-02 |
| 1205376977 | Peninsula Community Health Services | Dentist | 616 6th St, Bremerton, WA 98337-1420 | 2017-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902379563 | Paul Hastings | Physician Assistant | Peninsula Community Health Services, 400 Warren Ave, Suite 200, Bremerton, WA 98337 | 2019-01-07 |
| 1083199285 | Jacob Lawrence Barnes | Behavioral Analyst | 1709 13th St, Bremerton, WA 98337 | 2018-10-03 |
| 1295254092 | James Richard Mccormack | Counselor | 851 6th St Ste 135, Kitsap Hypnosis Center LLC, Bremerton, WA 98337 | 2017-09-12 |
| 1629593728 | Tina Mae Davis-munn | Registered Nurse | 345 6th St, Suite 300, Bremerton, WA 98337 | 2017-08-09 |
| 1962927384 | Linda Louise Tourigny | Registered Nurse | 345 6th St Suite 300, Bremerton, WA 98337 | 2017-08-07 |
| 1417480609 | Diane Marie Sabo | Counselor | 843 6th Street, Suite 220 and 240, Bremerton, WA 98337 | 2017-04-05 |
| 1659792265 | Allan L Hablutzel | Dentist | 820 Pacific Ave., Suite 204, Bremerton, WA 98337 | 2013-12-27 |
| 1881979722 | Sidestix Ventures Usa | Durable Medical Equipment & Medical Supplies | 410 Ida St. West, Ste 201, Bremerton, WA 98337 | 2011-10-11 |
| 1346545829 | Doyle & Associates Chiropractic Clinic Inc Ps | Chiropractor | 603 Chester Avenue, Bremerton, WA 98337 | 2011-01-14 |
| 1285762856 | Tracee Arlene Costa | Massage Therapist | 911 Adele Rd., Bremerton, WA 98337 | 2007-03-02 |
| Find all providers in zip 98337 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659792265 | Allan L Hablutzel | Dentist | 820 Pacific Ave., Suite 204, Bremerton, WA 98337 | 2013-12-27 |
| 1225150246 | Peter Anthony Ruff | Dentist | 629 Ne Riddell Rd Ste B, Bremerton, WA 98310-3028 | 2007-04-03 |
| 1053446435 | Larry K Heggerness | Dentist | 4110 Kitsap Way Ste 100, Bremerton, WA 98312-2401 | 2007-02-23 |
| 1740349687 | Hamidreza Barakhshan | Dentist | 4207 Wheaton Way, Suite C, Bremerton, WA 98310-3605 | 2006-12-06 |
| 1386711893 | Robert Bruce Robinson | Dentist | 5011 May St Nw, Bremerton, WA 98311-2342 | 2006-11-29 |
| 1346330644 | Patricia Joleen Weiss | Dentist | 3421 Kitsap Way, Ste F, Bremerton, WA 98312-2601 | 2006-10-15 |
| 1023123726 | Dr Allan Hablutzel | Dentist | 820 Pacific Ave, Ste 204, Bremerton, WA 98337 | 2006-08-20 |
| 1023049772 | Brian R Bowman | Dentist | 2554 Perry Ave, Bremerton, WA 98310-5219 | 2006-07-05 |
| 1962451948 | Terry A Schaap | Dentist | 2135 6th St, Bremerton, WA 98312-3957 | 2006-05-08 |
| 1720042765 | David W Kidd | Dentist | 1 Boone Rd # Code048, Bremerton, WA 98312-1894 | 2006-04-14 |
| Find all providers in BREMERTON | ||||
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| 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.