Healthcare Provider Details

I. General information

NPI: 1972503167
Provider Name (Legal Business Name): LINDA SUSAN KROOK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 07/30/2023
Certification Date: 07/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BOONE RD INTERNAL MEDICINE NAVY HOSPITAL
BREMERTON WA
98312-1894
US

IV. Provider business mailing address

14605 OLYMPIC VIEW LOOP RD NW
SILVERDALE WA
98383-9773
US

V. Phone/Fax

Practice location:
  • Phone: 360-475-4161
  • Fax:
Mailing address:
  • Phone: 360-204-5166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD00020575
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD 12547
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberGFE 49337
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD00020575
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: