Provider Demographics
NPI:1790139483
Name:NORTHWEST MEDICAL ALLIES PLLC
Entity Type:Organization
Organization Name:NORTHWEST MEDICAL ALLIES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSETT
Authorized Official - Middle Name:
Authorized Official - Last Name:POCUIS
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, ARNP
Authorized Official - Phone:360-536-2798
Mailing Address - Street 1:3709 NW 29TH ST
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-1966
Mailing Address - Country:US
Mailing Address - Phone:360-536-2798
Mailing Address - Fax:
Practice Address - Street 1:3100 NW BUCKLIN HILL RD
Practice Address - Street 2:SUITE # 105
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8358
Practice Address - Country:US
Practice Address - Phone:360-536-2798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty