PENINSULA PAIN CLINIC, PLLC


Address: 2601 Cherry Ave Ste 200, Bremerton, WA 98310-4208
Phone: 3604159110

PENINSULA PAIN CLINIC, PLLC (NPI# 1912376005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912376005
Entity Type Organization
Organization Name PENINSULA PAIN CLINIC, PLLC
Practice Address 2601 Cherry Ave Ste 200
Bremerton
WA 98310-4208
Mailing Address 2980 N Beverly Glen Cir Ste 100
Los Angeles
CA 90077-1728
Practice Telephone 3604159110
Practice Fax Number 3604790265
Mailing Telephone 3109434180
Mailing Fax Number 8884318819
Enumeration Date 2015-09-18
Last Update Date 2019-07-22
Authorized Official Name TERRY PEXTON (MEDICAL DIRECTOR)
Authorized Official Telephone 3604159110
Authorized Official Credential DO
Is Organization Subpart Y
Parent Organization Name PENINSULA PAIN CLINIC, PLLC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261Q00000X Clinic/Center Ambulatory Health Care Facilities
N 332900000X Non-Pharmacy Dispensing Site OP60339103 WA Suppliers
Y 261QP3300X Clinic/Center
Specialization: Pain
Ambulatory Health Care Facilities

Office Location

Street Address 2601 CHERRY AVE STE 200
City BREMERTON
State WA
Zip Code 98310-4208

Providers in the same location

NPI Name Taxonomy Address Enumeration
1184680498 Sound Pain Alliance Anesthesiology 2601 Cherry Ave Ste 200, Bremerton, WA 98310-4208 2006-04-25
1790325637 Marisa Lynne Bouquet Nurse Practitioner 2601 Cherry Ave Ste 200, Bremerton, WA 98310-4208 2020-01-08
1619481421 Tia Ramirez Registered Nurse 2601 Cherry Ave Ste 200, Bremerton, WA 98310-4208 2017-12-01
1790174142 Jessett Tyler Pocuis Nurse Practitioner 2601 Cherry Ave Ste 200, Bremerton, WA 98310-4208 2015-01-22
1770908907 Wesley D Sumrall Physician Assistant 2601 Cherry Ave Ste 200, Bremerton, WA 98310-4208 2014-02-25
1235256272 Vaughn Theodore Howe Physician Assistant 2601 Cherry Ave Ste 200, Bremerton, WA 98310-4208 2007-03-23

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1891333613 Miss Mary Community Development Voluntary or Charitable 1630 Trenton Avenue Apt 10, Bremerton, WA 98310 2019-12-11
1629636055 Puget Sound Work Injury Clinic, LLC Clinic/Center 812 Cherry Ct, Bremerton, WA 98310 2019-05-31
1538672530 Rachel E Mittelstaedt Parsons Dietitian, Registered 3059 Viewcrest Dr Ne, Bremerton, WA 98310 2017-11-13
1356888937 Sarah Hike Community Health Worker 900 Sheridan, Bremerton, WA 98310 2017-01-20
1073941142 Hana Singer Physical Therapy Assistant 3600 Forest Dr Ne, Bremerton, WA 98310 2013-10-28
1447508122 Kevin Lee Hathaway Mechanotherapist 3308 Veska Avenue, Bremerton, WA 98310 2012-08-28
1003163007 James Hyun Soo Lee Surgery Cvn 76 Uss Ronald Reagan, Bremerton, WA 98310 2012-08-08
1487936241 Karen S Casseday Nurse Practitioner 1740 Ne Riddell Rd Ste 110, Bremerton, WA 98310 2011-09-16
1740560572 Lauren P Foresman Physician Assistant 2709 Hemlock Street, Bremerton, WA 98310 2011-08-24
1538390059 Patricia L Rushon Speech-Language Pathologist 560 Lebo Blvd., Bremerton, WA 98310 2009-07-31
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Taxonomy Information

Taxonomy Code 261QP3300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Pain

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1114410495 Advanced Pain Care Ps Clinic/Center 300 Lilly Rd Ne Ste C, Olympia, WA 98506-5428 2018-06-11
1689912859 Seattle Pain and Wellness Institute Clinic/Center 4701 41st Ave., Sw, Suite 120, Seattle, WA 98116 2013-01-23
1669742714 B Fit Preventive Care Clinic Clinic/Center 1715 Pacific Ave N, Suite B, Long Beach, WA 98631-3604 2012-01-06
1053531780 Doctors Osteopathic Care Clinic/Center 9629 Evergreen Way Ste 102, Everett, WA 98204-7169 2007-04-26
1386751774 United Backcare Ps Clinic/Center 126 15th St Se, Puyallup, WA 98372-3409 2006-08-23
1568579944 United Backcare Ps Clinic/Center 9617 7th Ave Se, Everett, WA 98208-3710 2006-08-23
1023125499 United Backcare Ps Clinic/Center 2515 140th Ave Ne, Ste E110, Bellevue, WA 98005-1862 2006-08-23
1902420326 Sound Pain Alliance Pllc Clinic/Center 120 14th Ave Se Ste D, Puyallup, WA 98372-3718 2020-06-01
1134684079 John R Quigley Jr. Clinic/Center 129 176th St S, Spanaway, WA 98387-4616 2019-02-05
1376034694 Serendib Pain Care Pllc Clinic/Center 2312 Ne 129th St, Vancouver, WA 98686-3236 2018-05-22
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Competitor

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City BREMERTON
Zip Code 98310

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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