Provider Demographics
NPI:1598966848
Name:NAVAL HOSPITAL BREMERTON
Entity Type:Organization
Organization Name:NAVAL HOSPITAL BREMERTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:IDC
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:GUY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-315-4363
Mailing Address - Street 1:7300 MCCORMICK WOODS DR SW
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-7476
Mailing Address - Country:US
Mailing Address - Phone:360-874-0449
Mailing Address - Fax:
Practice Address - Street 1:2050 BARB ST STE A
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98315-2050
Practice Address - Country:US
Practice Address - Phone:360-315-4363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical TechniciansGroup - Multi-Specialty