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General NPI Number Information
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NPI Number | 1437330131
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Entity Type | Organization
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Legal Business Name | HEALTHCARE SYSTEM SERVICES INC
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 06/11/2010
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Provider Practice Location Address
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Address Line | 2528 WHEATON WAY STE 106
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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 | 360-782-1933
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Fax | 360-782-0131
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Provider Business Mailing Address
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Address Line | PO BOX 11810
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-5810
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Country | US
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Telephone | 206-501-2144
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Fax | 206-842-7400
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Authorized Official
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Title or Position | OWNER
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Name | TERRILYNN NICKLIN -GRISWOLD
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Credential |
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Telephone | 206-501-2144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH00010816
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License Number State | WA
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