Healthcare Provider Details

I. General information

NPI: 1336194869
Provider Name (Legal Business Name): CAPRI HEART & LUNG INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 01/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 CHERRY AVE #111
BREMERTON WA
98310-4203
US

IV. Provider business mailing address

2601 CHERRY AVE #111
BREMERTON WA
98310-4203
US

V. Phone/Fax

Practice location:
  • Phone: 360-479-3886
  • Fax: 360-479-0671
Mailing address:
  • Phone: 360-479-3886
  • Fax: 360-479-0671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number582
License Number StateWA

VIII. Authorized Official

Name: MR. RICHARD S HUDDY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 360-479-3886