Provider Demographics
NPI:1235340738
Name:LITTLER, EDWARD CLIFF (USN IDC)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:CLIFF
Last Name:LITTLER
Suffix:
Gender:M
Credentials:USN IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 GROWLER CR
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98315
Mailing Address - Country:US
Mailing Address - Phone:360-598-0227
Mailing Address - Fax:
Practice Address - Street 1:USS HENRY M JACKSON (SSBN 730)(BLUE)
Practice Address - Street 2:FPO AP
Practice Address - City:BANGOR
Practice Address - State:WA
Practice Address - Zip Code:98315
Practice Address - Country:US
Practice Address - Phone:360-990-9113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman