Healthcare Provider Details

I. General information

NPI: 1437330131
Provider Name (Legal Business Name): HEALTHCARE SYSTEM SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2007
Last Update Date: 06/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2528 WHEATON WAY STE 106
BREMERTON WA
98310-3305
US

IV. Provider business mailing address

PO BOX 11810
BAINBRIDGE ISLAND WA
98110-5810
US

V. Phone/Fax

Practice location:
  • Phone: 360-782-1933
  • Fax: 360-782-0131
Mailing address:
  • Phone: 206-501-2144
  • Fax: 206-842-7400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH00010816
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TERRILYNN NICKLIN -GRISWOLD
Title or Position: OWNER
Credential:
Phone: 206-501-2144