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NPI Code Detail

MEDICARE: DENNIS E. OTTEMILLER M.D.

MEDICARE: DENNIS E. OTTEMILLER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology PhysicianMD17921OR
2207W00000XOphthalmology PhysicianMD60903092WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1C70299OTHERUPIN

General Provider Information

NPI Number : 1649271487
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNIS E. OTTEMILLER M.D.
Provider Business Mailing Address
First Line : 20669 BOND RD NE
Second Line : STE 100
City : POULSBO
State : WA
Zip : 98370-6525
Country : US
Telephone Number : 541-756-2584
Fax Number : 541-756-5783
Provider Business Practice Location Address
First Line : 20669 BOND RD NE STE 100
Second Line :
City : POULSBO
State : WA
Zip : 98370-6525
Country : US
Telephone Number : 360-779-2020
Fax Number : 360-779-3093
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 03/07/2023

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Directions to “ DENNIS E. OTTEMILLER M.D.” Practice Location

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