1679628689 NPI number — AMY JO WESNER MA

Table of content: DR. KEVIN C. CONSIDINE D.O. (NPI 1215918271)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679628689 NPI number — AMY JO WESNER MA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WESNER
Provider First Name:
AMY
Provider Middle Name:
JO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679628689
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5455 ALMIRA DR SE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BREMERTON
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98311-8330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-373-5031
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
450 S KITSAP BLVD
Provider Second Line Business Practice Location Address:
STE 2600
Provider Business Practice Location Address City Name:
PORT ORCHARD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98366-3773
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-415-5868
Provider Business Practice Location Address Fax Number:
360-415-5872
Provider Enumeration Date:
01/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LH00007870 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 91102010689 . This is a "KITSAP PHYSICIANS SERVICE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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