Provider Demographics
NPI:1508898859
Name:KITSAP PUBLIC HEALTH DISTRICT
Entity Type:Organization
Organization Name:KITSAP PUBLIC HEALTH DISTRICT
Other - Org Name:FLU PNEUMO
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF HEALTH
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:W
Authorized Official - Last Name:LINDQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:360-337-5237
Mailing Address - Street 1:345 6TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98337-1866
Mailing Address - Country:US
Mailing Address - Phone:360-337-5235
Mailing Address - Fax:360-337-5298
Practice Address - Street 1:345 6TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98337-1866
Practice Address - Country:US
Practice Address - Phone:360-337-5235
Practice Address - Fax:360-337-5298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7138712Medicaid
WA7054109Medicaid
WA7054109Medicaid
WA7138712Medicaid