Provider Demographics
NPI:1598792814
Name:PERRY OCKERMAN, CHRISTINE M (D,O, MS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:M
Last Name:PERRY OCKERMAN
Suffix:
Gender:F
Credentials:D,O, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 CHICO WAY NW
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312
Mailing Address - Country:US
Mailing Address - Phone:734-626-0252
Mailing Address - Fax:
Practice Address - Street 1:2520 CHERRY AVE.
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310
Practice Address - Country:US
Practice Address - Phone:360-744-4949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101015754207P00000X
OH34C.000182207P00000X
WAOP00002240207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0153311475OtherBCBS INDIVIDUAL PIN
WA8485286Medicaid
MI4801073Medicaid
MI4801064Medicaid
MII45284Medicare UPIN
MI4801073Medicaid
WA8485286Medicaid
MIN37250033Medicare ID - Type Unspecified