MEDICARE: AMAN CHAVEZ HIDALGO WATSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN61102592	WA

General Provider Information

NPI Number	:	1114709532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMAN CHAVEZ HIDALGO WATSON

Provider Business Mailing Address
First Line	:	495 NE CONIFER DR
Second Line	:
City	:	BREMERTON
State	:	WA
Zip	:	98311-9223
Country	:	US
Telephone Number	:	360-525-0911
Fax Number	:	360-517-7525

Provider Business Practice Location Address
First Line	:	8124 E DANIELS LOOP
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98366-8654
Country	:	US
Telephone Number	:	206-458-0711
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2023
Last Update Date	:	03/03/2026

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