Olympic Peninsula Kidney Center

Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Bremerton, WA

NPI 1437109147 · NPPES record last updated Dec 15, 2009

Key facts

NPI
1437109147
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
Legal business name
OLYMPIC PENINSULA KIDNEY CENTER
Practice address
2613 Wheaton Way
Bremerton, WA 98310-3373
Phone
(360) 479-5908
Fax
(360) 479-5787
NPI assigned
May 11, 2006
Organization subpart
No

Authorized official

Name
Katrina Ardel Russell, RN, CNN
Title
Administrator
Phone
(206) 915-9502

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Yes

Addresses

Primary practice location

2613 Wheaton Way
Bremerton, WA 98310-3373

Mailing address

2613 Wheaton Way
Bremerton, WA 98310-3373
Phone (360) 479-5908

Other identifiers

IdentifierTypeStateIssuer
3999109MedicaidWA

Other providers in Bremerton, WA

All providers in Bremerton, WA · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Washington

Sources for this page

Verify at the official NPI Registry.