IndividualActive
Shane Walter, IDC
NPI 1316915309 · Independent Duty Corpsman · Silverdale, WA
Provider details
- NPI number
- 1316915309
- Entity type
- Individual
- Primary specialty
- Independent Duty CorpsmanOther Service Providers
- Credential
- IDC
- Sex
- Male
- License
- 0I1002X171 (WA)
Specialties & taxonomies
Other Service Providers
Practice location
Bhc Bangor, 2050 Barb St
Suite A, Naval Submarine Base Bangor
Silverdale, WA 98315-2099
Phone: (360) 315-4356
Fax: (360) 396-4247
Approximate (ZIP-level) locationGet directions
Mailing address
790 Ne Shorewood Ct
Poulsbo, WA 98370-8436
Registry dates
- Enumerated
- 2006-03-08
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.