NEOSPINE PUYALLUP SPINE CENTER, LLC (NPI# 1275510141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275510141 |
| Entity Type | Organization |
| Organization Name | NEOSPINE PUYALLUP SPINE CENTER, LLC |
| Other Organization Name | MICROSURGICAL SPINE CENTER |
| Practice Address |
1519 3rd St Se Suite 102 Puyallup WA 98372-3742 |
| Practice Telephone | 2538140705 |
| Practice Fax Number | 2538144527 |
| Mailing Telephone | 2538140705 |
| Mailing Fax Number | 2538144527 |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2014-04-24 |
| Authorized Official Name | MR. CLIFFORD G ADLERZ (CEO & PRESIDENT) |
| Authorized Official Telephone | 6152345900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
WA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Microsurgical Spine Center | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | NEOSPINE PUYALLUP SPINE CENTER, LLC | 310 Seven Springs Way, Suite 500, Brentwood, TN 37027-5679 |
| Street Address |
1519 3RD ST SE SUITE 102 |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98372-3742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831176999 | Helene Susan Dehaan | Nurse Practitioner | 1519 3rd St Se, Suite 101, Puyallup, WA 98372-3742 | 2005-12-29 |
| 1053764522 | Yarrow J. Mcconnell | Surgery | 1519 3rd St Se, Suite 230, Puyallup, WA 98372-3742 | 2016-07-19 |
| 1437443348 | Ryan J Street | Urology | 1519 3rd St Se, Suite 210, Puyallup, WA 98372-3742 | 2011-06-08 |
| 1417257668 | Eugenia Byrne | Nurse Practitioner | 1519 3rd St Se, Suite 101, Puyallup, WA 98372-3742 | 2010-10-21 |
| 1730331240 | Brent Sissom | Radiologic Technologist | 1519 3rd St Se, Suite 103, Puyallup, WA 98372-3742 | 2008-10-15 |
| 1174799282 | South Sound Neurosurgery Pllc | Clinic/Center | 1519 3rd St Se, Suite 103, Puyallup, WA 98372-3742 | 2008-05-08 |
| 1003094889 | Gregory Ryan Lamberton | Urology | 1519 3rd St Se, Ste 210, Puyallup, WA 98372-3724 | 2008-02-04 |
| 1801098405 | Robin Yune Lee | Urology | 1519 3rd St Se, Suite 210, Puyallup, WA 98372-3742 | 2007-06-05 |
| 1104048594 | Partner Oncology Inc | Clinic/Center | 1519 3rd St Se, Suite 260, Puyallup, WA 98372 | 2007-05-03 |
| 1235261884 | Apple Physical Therapy Ps | Durable Medical Equipment & Medical Supplies | 1519 3rd St Se, Suite 104, Puyallup, WA 98372-3742 | 2007-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371532 | Jeffrey Allen Zhan | Urology | Good Samaritan Medical Office Bldg 1450 5th St Se, Suite 2100- Urology Clinic, Puyallup, WA 98372 | 2019-11-21 |
| 1447811419 | Serenity Counseling & Consulting, LLC | Marriage & Family Therapist | 102 23rd St Se, Unit B, Puyallup, WA 98372 | 2019-06-21 |
| 1316401565 | Katherine Juarez Davidson | Nurse Practitioner | 325 E Pioneer # A145, Puyallup, WA 98372 | 2019-01-22 |
| 1679041404 | Cara Ann Lundin | Nurse Practitioner | 11926 43rd St Crt E, Edgewood, WA 98372 | 2018-11-09 |
| 1104392109 | Megan Black | Occupational Therapist | 40 29th St Ne, Puyallup, WA 98372 | 2018-10-17 |
| 1063919470 | Myriah Shekinah Olakpe | Occupational Therapist | 516 Se 23rd Ave, Puyallup, WA 98372 | 2018-04-11 |
| 1902330202 | Tyler Girdler | Student in an Organized Health Care Education/Training Program | 1322 3rd Street Se Suite 240, Puyallup, WA 98372 | 2017-04-13 |
| 1770039471 | Mahalakshmi Hariharan | Pharmacist | 2117 28th St Se, Puyallup, WA 98372 | 2016-09-01 |
| 1801241112 | Nawazish Ali | Internal Medicine | 401 15th Ave Se Multicare God Samartian Hopsital, Puyallup, WA 98372 | 2016-04-25 |
| 1932567559 | Denice L. Voss | Physical Therapist | 400 29th St. Ne, Puyallup, WA 98372 | 2016-02-10 |
| Find all providers in zip 98372 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104151562 | Ear Nose Throat & Plastic Surgery Associates of The South Sound Ps | Clinic/Center | 1609 S Meridian, Puyallup, WA 98371-7517 | 2009-10-02 |
| 1316175094 | Entpsa Puyallup Asc | Clinic/Center | 1609 S Meridian, Puyallup, WA 98371-7517 | 2009-07-01 |
| 1982853271 | Western Washington Endoscopy Centers LLC | Clinic/Center | 11216 Sunrise Blvd E, Suite 201, Bldg 3, Puyallup, WA 98374-8848 | 2008-09-11 |
| 1699817346 | Cascade Eye & Skin Centers PC | Clinic/Center | 1703 S Meridian, Suite 101, Puyallup, WA 98371-7590 | 2007-02-12 |
| 1215082557 | Auburn Outpatient Surgery Center, LLC | Clinic/Center | 208 17th Ave Se, Suite 202, Puyallup, WA 98372-4515 | 2007-01-25 |
| 1083622112 | Proliance Surgeons, Inc., P.s. | Clinic/Center | 1519 3rd St Se, Suite 240, Puyallup, WA 98372-3742 | 2006-08-04 |
| 1780610220 | Proliance Surgeons Inc Ps | Clinic/Center | 104 27th Ave Se, Puyallup, WA 98374-1145 | 2006-06-25 |
| 1972565745 | Proliance Surgeons, Inc., P.s. | Clinic/Center | 3801 5th St Se, Suite 210, Puyallup, WA 98374-2106 | 2006-04-05 |
| 1790744175 | Western Washington Endoscopy Centers LLC | Clinic/Center | 1703 S Meridian, Suite 203, Puyallup, WA 98371-7590 | 2006-03-22 |
| 1841286101 | Good Samaritan Surgery Center LLC | Clinic/Center | 1322 3rd St Se, 100, Puyallup, WA 98372-3771 | 2005-09-22 |
| Find all providers in PUYALLUP | ||||
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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.