THE IDA KARLIN PEDIATRIC CENTER (NPI# 1366657918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366657918 |
| Entity Type | Organization |
| Organization Name | THE IDA KARLIN PEDIATRIC CENTER |
| Practice Address |
319 5th St Sw Puyallup WA 98371-5828 |
| Practice Telephone | 2538480351 |
| Practice Fax Number | 2538411397 |
| Mailing Telephone | 2538480351 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2015-12-23 |
| Authorized Official Name | OVIDIO PENALVER (CORPORATE OFFICER, PROVIDER) |
| Authorized Official Telephone | 2538480351 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | LH60394287 | WA | Behavioral Health & Social Service Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
AP60312846 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP60311598 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 103T00000X | Psychologist | PY60385056 | WA | Behavioral Health & Social Service Providers |
| Y | 208000000X | Pediatrics | MD00015660 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7110653 | 05 |
| Street Address |
319 5TH ST SW |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98371-5828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457357964 | Ovidio Moises Penalver | Specialist | 319 5th St Sw, Puyallup, WA 98371-5828 | 2005-06-21 |
| 1336579424 | Laura Penalver-vargas | Psychologist | 319 5th St Sw, Puyallup, WA 98371-5828 | 2013-11-26 |
| 1740566306 | Julie Ann Aldrich Whalen | Nurse Practitioner | 319 5th St Sw, Puyallup, WA 98371-5828 | 2011-10-27 |
| 1326263039 | Nancy E. Heilman | Psychologist | 319 5th St Sw, Puyallup, WA 98371-5828 | 2007-04-16 |
| 1659322402 | Aaron Huston | Registered Nurse | 319 5th St Sw, Puyallup, WA 98371-5828 | 2006-05-15 |
| 1255337762 | Karen Boudour | Nurse Practitioner | 319 5th St Sw, Puyallup, WA 98371-5828 | 2005-06-21 |
| 1831195346 | Frank D'andrea | Specialist | 319 5th St Sw, Puyallup, WA 98371-5828 | 2005-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588141550 | Karen Lynn Sorensen | Massage Therapist | 922 Valley Ave Nw Suite 101, Puyallup, WA 98371 | 2018-07-23 |
| 1487140257 | Bradley Dupea | Specialist/Technologist | 5702 44th St Se, Puyallup, WA 98371 | 2018-07-05 |
| 1740778695 | Pedraum Heydari | Dentist | 109 N Meridian Suite A, Puyallup, WA 98371 | 2018-04-26 |
| 1487030359 | Jennifer Block | Dental Hygienist | 601 4th Ave Sw, Puyallup, WA 98371 | 2015-08-03 |
| 1023423431 | On Your Own Inc. | Registered Nurse | 1602 Peach Park Ln Nw, Puyallup, WA 98371 | 2014-06-24 |
| 1841614997 | Enrique Somera | Registered Nurse | 1107 29th St Nw, Puyallup, WA 98371 | 2014-02-10 |
| 1033540893 | Ching Ju Chuang | Dentist | 1002 N. Meridian, Suite 104a, Puyallup, WA 98371 | 2013-12-04 |
| 1104161876 | Denise L. Vanaman | Registered Nurse | 214 W. Main, Puyallup, WA 98371 | 2012-12-06 |
| 1336491018 | Tacoma School District | Physical Therapy Assistant | 1721 8th Ave. S.w., Puyallup, WA 98371 | 2012-10-05 |
| 1275882052 | Robert Francis Saxton | Health Educator | 1121 W. Stewart, Puyallup, WA 98371 | 2012-09-07 |
| Find all providers in zip 98371 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003921701 | Michael Lane Pearson | Pediatrics | 12904 94th Ave East, Puyallup, WA 98373 | 2006-08-20 |
| 1750303038 | Don R Russell | Pediatrics | 1910 S Meridian, Suite A, Puyallup, WA 98371-7531 | 2006-07-24 |
| 1851368575 | Shabnam Barnhart | Pediatrics | 1706 S. Meridian, Suite 130, Puyallup, WA 97371 | 2006-03-01 |
| 1366428369 | Roselynn Wee Sim Cuenca | Pediatrics | 1910 Meridian St S, Ste A, Puyallup, WA 98371-7531 | 2005-12-21 |
| 1407242530 | Taylor Ryan Mclain | Pediatrics | 11102 Sunrise Blvd E Ste 103, Puyallup, WA 98374 | 2015-04-15 |
| 1700298148 | Erin Colleen Donahue | Pediatrics | 1706 S. Meridian, Suite 120, Puyallup, WA 98371 | 2014-05-20 |
| 1679760755 | Suzanne Amalie Ingrao | Pediatrics | 407 14th Ave Se, Puyallup, WA 98372-3770 | 2007-10-02 |
| 1407907504 | Timothy B Jolley | Pediatrics | 1322 3rd St Se Ste 240, Puyallup, WA 98372-3771 | 2007-01-15 |
| 1578671830 | Mazen Dahan | Pediatrics | 120 14th Ave Se, Suite A, Puyallup, WA 98372 | 2006-08-28 |
| 1467472225 | Melanie A Roscoe | Pediatrics | 11102 Sunrise Blvd E, Suite 103, Puyallup, WA 98374 | 2006-07-21 |
| 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.