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General NPI Number Information
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NPI Number | 1427474790
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Entity Type | Organization
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Legal Business Name | NORTHWEST PSYCHIATRY INC PS
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Dates
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Enumeration Date | 03/11/2014
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Last Update Date | 03/16/2015
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Provider Practice Location Address
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Address Line | 2528 WHEATON WAY STE 204
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City | BREMERTON
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State | WA
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Zip | 98310-3305
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Country | US
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Telephone | 360-627-9219
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Fax | 369-627-9288
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Provider Business Mailing Address
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Address Line | 2528 WHEATON WAY STE 204
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City | BREMERTON
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State | WA
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Zip | 98310-3305
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Country | US
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Telephone | 360-627-9219
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Fax | 360-627-9288
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CHERYL SILVES
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Credential |
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Telephone | 360-627-9219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP30003880
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | MD00033182
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License Number State | WA
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