Provider Demographics
NPI:1831552629
Name:DE LUCA-WESTRATE, AMADEO JORGE (MD)
Entity type:Individual
Prefix:DR
First Name:AMADEO
Middle Name:JORGE
Last Name:DE LUCA-WESTRATE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NAVAL HOSPITAL BREMERTON
Mailing Address - Street 2:1 BOONE RD
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312
Mailing Address - Country:US
Mailing Address - Phone:360-475-4180
Mailing Address - Fax:360-475-4825
Practice Address - Street 1:NAVAL HOSPITAL BREMERTON
Practice Address - Street 2:1 BOONE RD
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312
Practice Address - Country:US
Practice Address - Phone:360-475-4180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA151517207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine