| |
463 Tremont St W Ste 200 Port Orchard WA 98366-0000 | |
(360) 876-2434 | |
(360) 876-2696 |
Full Name | |
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Speciality | Clinic/Center |
Location | 463 Tremont St W, Port Orchard, Washington |
Authorized Official Name and Position | Brad R Frandsen (PRESIDENT) |
Authorized Official Contact | 3608762434 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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463 Tremont St W Ste 200 Port Orchard WA 98366-3743 Ph: (360) 876-2434 | 463 Tremont St W Ste 200 Port Orchard WA 98366-0000 Ph: (360) 876-2434 |
NPI Number | 1306971296 |
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Provider Enumeration Date | 02/22/2007 |
Last Update Date | 04/28/2017 |
Medicare PECOS PAC ID | 5092819011 |
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Medicare Enrollment ID | O20070402000277 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306971296 | NPI | - | NPPES |
7134620 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | MD00029864 (Washington) | Primary |
Provider Name | Brad R Frandsen |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1700820966 PECOS PAC ID: 0042257925 Enrollment ID: I20050412001056 |
Provider Name | Melissa Renee Means |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275029621 PECOS PAC ID: 4486906930 Enrollment ID: I20181010002608 |
Provider Name | Katelyn M Neufeld |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689289357 PECOS PAC ID: 0941610380 Enrollment ID: I20201113001074 |
Peninsula Community Health Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2150 Fircrest Dr Se Rm G-1, Port Orchard, WA 98366 Phone: 360-377-3776 | |
Eppel Family Medicine Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1950 Pottery Ave, Ste 140, Port Orchard, WA 98366 Phone: 360-876-5440 Fax: 360-876-0718 | |
Peninsula Community Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1338 Sw Old Clifton Rd Ste E, Port Orchard, WA 98367 Phone: 360-377-3776 | |