Provider Demographics
NPI:1730134206
Name:NAVAL HEALTH CLINIC OAK HARBOR
Entity Type:Organization
Organization Name:NAVAL HEALTH CLINIC OAK HARBOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DHA FINANCIAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:CONDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-401-3643
Mailing Address - Street 1:3475 N SARATOGA ST
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98278-8800
Mailing Address - Country:US
Mailing Address - Phone:360-257-9500
Mailing Address - Fax:
Practice Address - Street 1:3475 N SARATOGA ST
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98278-8800
Practice Address - Country:US
Practice Address - Phone:360-257-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVAL HEALTH CLINIC OAK HARBOR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-23
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM1100X
WA286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital
Yes261QM1100XAmbulatory Health Care FacilitiesClinic/CenterMilitary/U.S. Coast Guard Outpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAVAD000Medicare UPIN