| Kitsap Eye Physicians Ps | |
|
2655 Wheaton Way, Bremerton, WA 98310-3318 | |
| (360) 377-3703 | |
| (360) 377-9469 |
| Full Name | Kitsap Eye Physicians Ps |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 2655 Wheaton Way, Bremerton, Washington |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174732556 | NPI | - | NPPES |
| 7071863 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
| Provider Name | Preston Sullivan |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1275696056 PECOS PAC ID: 6002896214 Enrollment ID: I20040923000474 |
| Provider Name | Debra M Sorensen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1245409036 PECOS PAC ID: 8123184066 Enrollment ID: I20090302000471 |
| Provider Name | Dale Norman Holdren |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1275612277 PECOS PAC ID: 8820985120 Enrollment ID: I20100921000619 |
| Provider Name | Jason George Gagnon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1730268731 PECOS PAC ID: 0345366878 Enrollment ID: I20100922000150 |
| Provider Name | Kenton Scott Sorensen |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1467531459 PECOS PAC ID: 7719003870 Enrollment ID: I20100925000342 |
| Provider Name | John V Hardaway |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1518930858 PECOS PAC ID: 6507055977 Enrollment ID: I20110117000198 |
| Provider Name | Shamis Fallah |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1780947549 PECOS PAC ID: 6305215716 Enrollment ID: I20240221002252 |
| Provider Name | Hui Zhao |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1154842979 PECOS PAC ID: 5193097921 Enrollment ID: I20241216001539 |
| Mailing Address | Practice Location Address |
|---|---|
| Kitsap Eye Physicians Ps 2655 Wheaton Way, Bremerton, WA 98310-3318 Ph: (360) 377-3703 | Kitsap Eye Physicians Ps 2655 Wheaton Way, Bremerton, WA 98310-3318 Ph: (360) 377-3703 |