Peninsula Pain Clinic, Pllc

NPI #1912376005 in Bremerton, Washington

Provider Information

NPI Number: 1912376005
Entity Type: Organization
Organization Name: Peninsula Pain Clinic, Pllc
Subpart: Yes (part of a larger organization)
Parent Organization: PENINSULA PAIN CLINIC, PLLC
Primary Specialty: Clinic/Center - Pain
Enumeration Date: Sep 18, 2015
Last Updated: Jul 22, 2019

Practice Location

Address: 2601 CHERRY AVE STE 200
City: Bremerton
State: Washington
ZIP Code: 98310-4208
Phone: (360) 415-9110

Authorized Official

Name: TERRY PEXTON, DO
Title: MEDICAL DIRECTOR
Phone: (360) 415-9110

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X
Non-Pharmacy Dispensing Site	332900000X
Clinic/Center - Pain — Pain	261QP3300X	Primary

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