Organization · Type 2 NPI
Peninsula Pain Clinic, PLLC
Pain Clinic/Center · Bremerton, WA
NPI number
1912376005
Active
Practice location
2601 Cherry Ave Ste 200
Bremerton, WA 98310-4208
Fax (360) 479-0265
Mailing address
2980 N Beverly Glen Cir Ste 100
Los Angeles, CA 90077-1728
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center | 261Q00000X | None listed |
| Pain Clinic/Center Primary | 261QP3300X | None listed |
| Non-Pharmacy Dispensing Site | 332900000X | OP60339103 (WA) |
Pain Clinic/Center: Definition to come...
3 other providers at this address
About NPI 1912376005
Peninsula Pain Clinic, PLLC's National Provider Identifier is 1912376005, issued on Sep 18, 2015. The primary taxonomy on file is Pain Clinic/Center (261QP3300X), and the practice location is in Bremerton, WA. The record was last updated on Jul 22, 2019.