Healthcare Provider Details

I. General information

NPI: 1801842992
Provider Name (Legal Business Name): CATHERINE P GOMES ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 11/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 CHERRY AVE #213
BREMERTON WA
98310-4203
US

IV. Provider business mailing address

2601 CHERRY AVE #213
BREMERTON WA
98310-4203
US

V. Phone/Fax

Practice location:
  • Phone: 360-479-6041
  • Fax: 360-405-0768
Mailing address:
  • Phone: 360-479-6041
  • Fax: 360-405-0768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP30001302
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: