NPIMap

Organization Active NPI

Peninsula Community Health Services

  • Community/Retail Pharmacy
  • Poulsbo, WA
National Provider Identifier
1760617997
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
CF60084120 Issued in WA
Legal business name
PENINSULA COMMUNITY HEALTH SERVICES
Practice address
19917 7TH Ave NE Ste 205
Suite 205
Poulsbo, WA 98370-6555
Phone
(360) 697-7636
Fax
(360) 697-7676
NPI assigned
May 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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) 478-2366

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X CF60084120 WA Primary

Addresses

Primary practice location

19917 7TH Ave NE Ste 205
Suite 205
Poulsbo, WA 98370-6555

Mailing address

PO Box 960
Bremerton, WA 98337-0212
Phone (360) 475-3731

Other identifiers 2

IdentifierTypeStateIssuer
6032270MedicaidWA
2120260OtherPK

Other names 1

  • Peninsula Community Health Services Pharmacy-Poulsbo Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Peninsula Community51 organizations share this tax ID, including this one

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1760617997",
    "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": "360-475-3731",
            "fax_number": "360-475-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19917 7TH AVE NE STE 205",
            "address_2": "SUITE 205",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706555",
            "telephone_number": "360-697-7636",
            "fax_number": "360-697-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA COMMUNITY HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-18",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "KREIDLER-MOSS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "360-478-2366"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF60084120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6032270",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2120260",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peninsula Community Health Services Pharmacy-Poulsbo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.