Active NPI
Peninsula Community Health Services
- Federally Qualified Health Center (FQHC)
- Bremerton, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- PENINSULA COMMUNITY HEALTH SERVICES
- Practice address
- 2720 Clare Ave
Bremerton, WA 98310-3374 - Phone
- (360) 377-3776
- NPI assigned
- Apr 18, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer Kreidler-Moss
- Title
- Ceo
- Phone
- (360) 377-3776
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Social Worker | 104100000X | |||
| Nutritionist | 133N00000X | |||
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | |||
| Pediatrics Physician | 208000000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Primary | ||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X | |||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X |
Addresses
Primary practice location
2720 Clare Ave
Bremerton, WA 98310-3374
Mailing address
PO Box 960
Bremerton, WA 98337-0212
Phone (360) 377-3776
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221025001747 | WA | Part A Provider - Federally Qualified Health Center (FQHC) | 9436044781 | Practice locations: Bremerton, WA |
Federally qualified health center certification: CCN 501010
- Legal name
- PENINSULA COMMUNITY HEALTH SERVICES
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Oct 11, 2022
- Last certification
- Oct 11, 2022
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Enrollment address
- 2720 Clare Ave
Bremerton, WA 98310-3374
National Provider Directory
National Provider Directory- Tax ID family
- Peninsula Community
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Federally Qualified Health Center (FQHC)
- Silverdale, WA
- NPI 1578163317
-
- Dentist
- Port Orchard, WA
- NPI 1588041701
-
- Community/Retail Pharmacy
- Port Orchard, WA
- NPI 1588675623
-
- Federally Qualified Health Center (FQHC)
- Silverdale, WA
- NPI 1598349003
-
- Federally Qualified Health Center (FQHC)
- Kingston, WA
- NPI 1639812589
-
- Dentist
- Belfair, WA
- NPI 1679023493
-
- Federally Qualified Health Center (FQHC)
- Bremerton, WA
- NPI 1679216501
-
- Federally Qualified Health Center (FQHC)
- Port Orchard, WA
- NPI 1699573634
-
- Federally Qualified Health Center (FQHC)
- Bremerton, WA
- NPI 1700529658
-
- Federally Qualified Health Center (FQHC)
- Bremerton, WA
- NPI 1700703758
-
- Dental Hygienist
- Bremerton, WA
- NPI 1720538986
-
- General Practice Dentistry
- Bremerton, WA
- NPI 1740630128
Locations
1500 13th St
Ste 114
Bremerton, WA 98337
26201 Siyaya Ave NE
Rm 121
Kingston, WA 98346
Ownership & related parties
All disclosed owners & managing parties 16
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Christopher J Cook | Corporate Director | Sep 16, 2022 | |
| Jennifer Kreidler-Moss | Corporate Officer | Aug 1, 2015 | 100% |
| W-2 Managing Employee | Aug 1, 2015 | 100% | |
| Operational/Managerial Control | Aug 1, 2015 | 100% | |
| Susan Astle | Corporate Director | Sep 16, 2022 | |
| Monica Bernhard | Corporate Director | Sep 16, 2022 | |
| Yolanda N Fong | Corporate Director | Sep 18, 2024 | |
| Neal Schanbeck | Corporate Director | Dec 17, 2025 | |
| Lolita Afalla | Corporate Director | Sep 18, 2024 | |
| Leslie Jackson | Corporate Director | Nov 19, 2025 | |
| Mary Berglind | Corporate Director | Feb 1, 2023 | |
| Kristin Lillegard | Corporate Director | Feb 18, 2026 | |
| Alfred D Pinkham | Corporate Director | Sep 16, 2022 | |
| Mary Dixon | Corporate Director | Aug 20, 2025 | |
| David Windom | Corporate Director | Sep 16, 2022 | |
| Peninsula Community Health Services | 5% Or Greater Direct Ownership Interest | Sep 16, 2022 | |
| Operational/Managerial Control | Sep 16, 2022 | ||
| Rogelio Valencia | Corporate Director | Feb 1, 2023 | |
| Shannon Turner | Corporate Director | May 21, 2025 |
All facility ownership & control disclosures 26
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Kitsap Community Health Centers | Federally qualified health center | Operational/Managerial Control | Jan 1, 2016 |
| Peninsula Community Health Services | Federally qualified health center | Operational/Managerial Control | Jan 1, 2016 |
| Peninsula Community Health Services | Federally qualified health center | Operational/Managerial Control | Jan 1, 2016 |
| Peninsula Community Health Services Belfair | Federally qualified health center | Operational/Managerial Control | Apr 1, 2017 |
| Peninsula Community Health Services Kingston | Federally qualified health center | Operational/Managerial Control | May 1, 2017 |
| Peninsula Community Health Services | Federally qualified health center | Operational/Managerial Control (100%) | Jan 1, 2019 |
| Peninsula Community Health Services | Federally qualified health center | Operational/Managerial Control | Sep 3, 2019 |
| Peninsula Community Health Services | Federally qualified health center | Operational/Managerial Control | Sep 3, 2019 |
| Peninsula Community Health Services | Federally qualified health center | Operational/Managerial Control (100%) | Sep 3, 2019 |
| Peninsula Community Health Services | Federally qualified health center | Operational/Managerial Control (100%) | Sep 3, 2019 |
| Peninsula Community Health Services | Federally qualified health center | Operational/Managerial Control | May 1, 2020 |
| Peninsula Community Health Services | Federally qualified health center | Operational/Managerial Control (100%) | Apr 20, 2020 |
| Peninsula Community Health Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Nov 17, 2021 Nov 17, 2021 |
| Peninsula Community Health Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
May 31, 2022 May 31, 2022 |
| Peninsula Community Health Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest Operational/Managerial Control |
Sep 24, 2021 Sep 24, 2021 |
| Peninsula Community Health Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest Operational/Managerial Control |
Oct 1, 2021 Oct 1, 2021 |
| Peninsula Community Health Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest Operational/Managerial Control |
Apr 14, 2022 Apr 14, 2022 |
| Peninsula Community Health Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest | Apr 14, 2022 |
| Peninsula Community Health Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest | Aug 23, 2022 |
| Peninsula Community Health Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest | Sep 24, 2021 |
| Peninsula Community Health Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest Operational/Managerial Control |
Sep 8, 2023 Sep 8, 2023 |
| Peninsula Community Health Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest Operational/Managerial Control |
Sep 8, 2023 Sep 8, 2023 |
| Peninsula Community Health Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Nov 1, 2023 Nov 1, 2023 |
| Peninsula Community Health Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest | Feb 5, 2025 |
| Peninsula Community Health Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest Operational/Managerial Control |
Jun 1, 2025 Jun 1, 2025 |
| Peninsula Community Health Services | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 12, 2026 Jan 12, 2026 |
Facilities with the same owner 26
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Federally Qualified Health Center (FQHC)
- Port Orchard, WA
- NPI 1053995340
Peninsula Community Health Services
-
- Federally Qualified Health Center (FQHC)
- Bremerton, WA
- NPI 1053995845
Peninsula Community Health Services
-
- Federally Qualified Health Center (FQHC)
- Port Orchard, WA
- NPI 1205886934
Peninsula Community Health Services
-
- Federally Qualified Health Center (FQHC)
- Bremerton, WA
- NPI 1235759879
Peninsula Community Health Services
-
- Federally Qualified Health Center (FQHC)
- Poulsbo, WA
- NPI 1265217517
Peninsula Community Health Services
-
- Federally Qualified Health Center (FQHC)
- Bremerton, WA
- NPI 1356995534
Peninsula Community Health Services
-
- Federally Qualified Health Center (FQHC)
- Bremerton, WA
- NPI 1407400682
Peninsula Community Health Services
-
- Federally Qualified Health Center (FQHC)
- Silverdale, WA
- NPI 1437830007
Peninsula Community Health Services
-
- Federally Qualified Health Center (FQHC)
- Silverdale, WA
- NPI 1497530570
Peninsula Community Health Services
-
- Federally Qualified Health Center (FQHC)
- Belfair, WA
- NPI 1528517216
Peninsula Community Health Services
-
- Federally Qualified Health Center (FQHC)
- Shelton, WA
- NPI 1538643853
Peninsula Community Health Services
-
- Federally Qualified Health Center (FQHC)
- Gig Harbor, WA
- NPI 1558935940
Peninsula Community Health Services
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Bremerton, WA
- NPI 1407680887
Nurse Practitioner
-
- Psychiatry Physician
- Bremerton, WA
- NPI 1568958296
-
- Physician Assistant
- Bremerton, WA
- NPI 1740707512
-
- Pharmacist
- Bremerton, WA
- NPI 1841017894
-
- Pharmacist
- Bremerton, WA
- NPI 1730907585
-
- Medical Physician Assistant
- Bremerton, WA
- NPI 1710683099
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650240000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1779926400000",
"number": "1730822602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 960",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983370212",
"telephone_number": "360-377-3776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2720 CLARE AVE",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983103374",
"telephone_number": "360-377-3776"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PENINSULA COMMUNITY HEALTH SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2022-04-18",
"last_updated": "2026-05-28",
"certification_date": "2026-05-28",
"status": "A",
"authorized_official_last_name": "KREIDLER-MOSS",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "360-377-3776"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "133N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nutritionist",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": null,
"license": null,
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bremerton, WA
- Peninsula Community Health Services
- Peninsula Community Health Services
- Peninsula Community Health Services
- Peninsula Community Health Services
- Peninsula Community Health Services
- Peninsula Community Health Services
- Peninsula Community Health Services
- Peninsula Community Health Services
- Peninsula Community Health Services
- Peninsula Community Health Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.