Healthcare Provider Details

I. General information

NPI: 1639346091
Provider Name (Legal Business Name): DOCTORS CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2008
Last Update Date: 04/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 NW MYHRE RD
SILVERDALE WA
98383-7681
US

IV. Provider business mailing address

2512 WHEATON WAY
BREMERTON WA
98310-3399
US

V. Phone/Fax

Practice location:
  • Phone: 360-830-1100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number StateWA

VIII. Authorized Official

Name: LINDA A. BROWN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 360-782-3600