DEO SAMSON MACABIO PEREZ (NPI# 1033305826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033305826 |
Entity Type | Individual |
Full Name | DEO SAMSON MACABIO PEREZ |
Credential | PAC |
Practice Address |
3124 S 19th St Suite 320 Tacoma WA 98405-2433 |
Practice Telephone | 2533015100 |
Practice Fax Number | 2533015101 |
Mailing Telephone | 2533015100 |
Mailing Fax Number | 2533015101 |
Enumeration Date | 2007-09-14 |
Last Update Date | 2014-06-27 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA10005222 | WA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
3124 S 19TH ST SUITE 320 |
City | TACOMA |
State | WA |
Zip Code | 98405-2433 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407848559 | Mark Schomogyi | Internal Medicine | 3124 S 19th St, Ste 240, Tacoma, WA 98405-2433 | 2005-08-16 |
1083052583 | Kimberley Ann Marin | Nurse Practitioner | 3124 S 19th St, Ste 340, Tacoma, WA 98405-2433 | 2013-06-06 |
1699066530 | Hossein Pakzad Sedigh | Orthopaedic Surgery | 3124 S 19th St, Ste 340, Tacoma, WA 98405-2433 | 2011-04-26 |
1790004844 | Catherine Grace Engibous Holder | Physician Assistant | 3124 S 19th St, Tacoma, WA 98405-2433 | 2010-05-27 |
1407017510 | Lili Yao | Internal Medicine | 3124 S 19th St, Tacoma, WA 98405-2433 | 2008-06-20 |
1013117803 | Jesse Lee Mierzwiak | Urology | 3124 S 19th St, Ste 320, Tacoma, WA 98405-2433 | 2007-07-20 |
1750582235 | Bobby Anthony Stevens | Surgery | 3124 S 19th St, Ste C220, Tacoma, WA 98405-2433 | 2007-05-30 |
1386709384 | Viet H Nguyen | Registered Nurse | 3124 S 19th St, Ste 140, Tacoma, WA 98405-2433 | 2006-12-27 |
1538241930 | John Anthony Vaccaro | Urology | 3124 S 19th St, Ste 320, Tacoma, WA 98405-2433 | 2006-10-19 |
1235210493 | Douglas E Sutherland | Urology | 3124 S 19th St, Ste 240, Tacoma, WA 98405-2433 | 2006-10-17 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609486026 | Joanna Christine Hope | Physician Assistant | 2502 S Union Avenue, Tacoma, WA 98405 | 2020-08-01 |
1467077891 | Richard Jimenez | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way Suite #310, Tacoma, WA 98405 | 2020-06-11 |
1669008785 | Mariana Sanchez Corona | Behavior Technician | 1901 S Union Ave Allenmore Building B, Tacoma, WA 98405 | 2020-03-20 |
1811534845 | Jasmine Gregory | Social Worker | 311 Martin Luther King Jr. Way, Ms:315-c2-php, Tacoma, WA 98405 | 2019-12-10 |
1548807506 | Holly Rebecca Brezynski | Student in an Organized Health Care Education/Training Program | Fresenius Kindney Care - Home Therapies Department, 1717 South J Street, Tacoma, WA 98405 | 2019-12-09 |
1972064392 | Logan Brau | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way, Tacoma, WA 98405 | 2019-03-28 |
1629532536 | Preferred Orthotic and Prosthetic Services Inc | Prosthetic/Orthotic Supplier | 1708 Yakima Ave Ste 60, Tacoma, WA 98405 | 2019-01-24 |
1669945911 | Heidi Weakley | Counselor | 1001 S Yakima Ave, Suite 5, Tacoma, WA 98405 | 2019-01-09 |
1972074011 | Taviance Benet Laster | Behavior Technician | 1416 S 9th St, Tacoma, WA 98405 | 2018-12-16 |
1336618040 | Bailey Bangerter | Physician Assistant | 1901 South Union, A-233, Tacoma, WA 98405 | 2018-11-26 |
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Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124147087 | Aniko A Szentes | Physician Assistant | 3708 55th St Ne, Tacoma, WA 98422-4571 | 2007-03-29 |
1053324186 | Tommy Lamar Jackson | Physician Assistant | 1802 Yakima Ave Ste 204, Tacoma, WA 98405-5304 | 2006-08-13 |
1396763140 | Jerry John Papson | Physician Assistant | 1812 South J St, Suite 210, Tacoma, WA 98405-4964 | 2006-07-18 |
1215996798 | Jill Tricia Eggersknight | Physician Assistant | Orthopedic Surgery Service, Attn: Mchj-sop, Tacoma, WA 98431-0001 | 2006-03-22 |
1588127062 | Sung Ho Kim | Physician Assistant | 1724 W Union Ave Ste 100, Tacoma, WA 98405-2099 | 2019-04-10 |
1215407770 | Monica Huang | Physician Assistant | 1724 W Union Ave Ste 100, Tacoma, WA 98405-2099 | 2018-11-27 |
1154803237 | Limary Gonzalez | Physician Assistant | 1717 S J St, Tacoma, WA 98405-4933 | 2018-09-05 |
1942725072 | Breanna Lynn Polk | Physician Assistant | 1724 W Union Ave, Tacoma, WA 98405-2099 | 2017-08-09 |
1104354190 | Samantha Sokol | Physician Assistant | 1717 S J St, Tacoma, WA 98405-4933 | 2017-06-02 |
1548662752 | Tomasz Gondek | Physician Assistant | 209 Martin Luther King Jr Way, Tacoma, WA 98405-4265 | 2014-09-18 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.