Bremerton Vascular Imaging LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

BREMERTON VASCULAR IMAGING LLC

Practice address

5610 Kitsap Way Ste 365
Bremerton, WA 98312-2266

Phone

(541) 760-8214

NPI assigned

Mar 11, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brooke JacksonNPI 1336078971

Title

Authorized Official / Sonographer

Phone

(541) 760-8214

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brooke Jackson, BS, RVT

  • Vascular Sonography Radiologic Technologist
  • Bremerton, WA
  • NPI 1336078971
  NPD Authorized official
• Mark S. Kim, MD

  • Phlebology Physician
  • Puyallup, WA
  • NPI 1053403634
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1773187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780617600000",
    "number": "1104773126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5610 KITSAP WAY STE 365",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983122266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5610 KITSAP WAY STE 365",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983122266",
            "telephone_number": "541-760-8214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREMERTON VASCULAR IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-11",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL / SONOGRAPHER",
        "authorized_official_telephone_number": "541-760-8214"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bremerton Health, LLC
• Bremerton Housing Authority
• Bremerton MC Operations, LLC
• Bremerton Physical Therapy
• Bremerton School District
• Bremerton Wellness PS
• Erika Brende, AAC
• Christine Brennan
• Anna Bresette
• Deborah M. Brewczynski, CCC SLP

• Clinic/Center in Bremerton, WA
• Providers in Bremerton, WA by specialty
• Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.