PUGET SOUND SPECIALTY PHYSICIANS PLLC (NPI# 1477732055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477732055 |
| Entity Type | Organization |
| Organization Name | PUGET SOUND SPECIALTY PHYSICIANS PLLC |
| Other Organization Name | ANKLE & FOOT SPECIALIST OF PUYALLUP |
| Practice Address |
3908 10th St Se Puyallup WA 98374-2188 |
| Mailing Address |
2728 E Main Ave Suite A Puyallup WA 98372-3198 |
| Practice Telephone | 2538486656 |
| Practice Fax Number | 2538406691 |
| Mailing Telephone | 2538412006 |
| Mailing Fax Number | 2538406691 |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2008-06-05 |
| Authorized Official Name | TINA M QUEVEDO (BILLING OFFICE SUPERVISOR) |
| Authorized Official Telephone | 2538412006 |
| Is Organization Subpart | Y |
| Parent Organization Name | PUGET SOUND SPECIALTY PHYSICIANS PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
WA | Podiatric Medicine & Surgery Service Providers |
| Other Name | Type Code |
|---|---|
| Ankle & Foot Specialist of Puyallup | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144401704 | Puget Sound Specialty Physicians Pllc | Podiatrist | 19820 Hwy 410 East, Bonney Lake, WA 98391 | 2007-11-23 |
| 1124203963 | Puget Sound Specialty Physicians Pllc | Podiatrist | 2728 E Main Ave, Suite A, Puyallup, WA 98372-3198 | 2007-12-28 |
| 1770766271 | Puget Sound Specialty Physicians Pllc | Podiatrist | 2820 Griffin Ave, Suite 101, Enumclaw, WA 98022-2373 | 2007-12-07 |
| 1760661334 | Puget Sound Specialty Physicians Pllc | Podiatrist | 4140 Factoria Blvd Se, Suite 1b, Bellevue, WA 98006-5261 | 2007-10-30 |
| 1114106796 | Puget Sound Specialty Physicians Pllc | Podiatrist | 2005 Nw Sammamish Rd, Issaquah, WA 98027-8940 | 2007-10-30 |
| 1588843254 | Puget Sound Specialty Physicians Pllc | Podiatrist | 2728 E Main Ave, Suite A, Puyallup, WA 98372-3198 | 2007-10-30 |
| Street Address |
3908 10TH ST SE |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98374-2188 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750366670 | Donald Edward Prater | Physician Assistant | 3908 10th St Se, Puyallup, WA 98374-2188 | 2005-12-14 |
| 1356957294 | Shannon Marie Peerboom | Nurse Practitioner | 3908 10th St Se, Puyallup, WA 98374-2188 | 2020-09-16 |
| 1578176285 | Gillian Mcravin-johnson | Nurse Practitioner | 3908 10th St Se, Puyallup, WA 98374-2188 | 2020-08-24 |
| 1235740499 | Mandeep Parmar Schaff | Nurse Practitioner | 3908 10th St Se, Puyallup, WA 98374-2188 | 2020-08-12 |
| 1699326553 | Jessica Hoover | Nurse Practitioner | 3908 10th St Se, Puyallup, WA 98374-2188 | 2019-09-23 |
| 1639727977 | Joslyn A Tapec | Nurse Practitioner | 3908 10th St Se, Puyallup, WA 98374-2188 | 2019-08-29 |
| 1790331163 | Francis E Prince | Nurse Practitioner | 3908 10th St Se, Puyallup, WA 98374-2188 | 2019-08-12 |
| 1306309034 | April Gail Lyman Telan | Nurse Practitioner | 3908 10th St Se, Puyallup, WA 98374 | 2019-04-10 |
| 1669914354 | Amandeep Kaur Mann | Nurse Practitioner | 3908 10th St Se, Puyallup, WA 98374-2188 | 2016-11-10 |
| 1346623196 | Megan Clarno | Physician Assistant | 3908 10th St Se, Puyallup, WA 98374-2188 | 2015-06-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073173977 | Courtney Yant | Registered Nurse | 300 3rd St Se, Puyallup, WA 98374 | 2019-06-13 |
| 1013480508 | Tracy Pina | Massage Therapist | 16909 123rd Ave E, Puyallup, WA 98374 | 2019-01-07 |
| 1922524917 | Edith M Wood | Registered Nurse | 13517 152nd St Ct E, Puyallup, WA 98374 | 2017-08-21 |
| 1669875993 | Jillian C S Longway | Registered Nurse | 11102 Sunrise Blvd E Ste 103, Puyallup, WA 98374 | 2014-10-01 |
| 1427302025 | Nadeem Jaffer | Internal Medicine | 3800 3rd St. Se, Puyallup, WA 98374 | 2012-11-04 |
| 1851605356 | Madigan Army Medical Ctr | Clinic/Center | 15600 Meridan Ave, Sunrise Village Center, East Puyallup, WA 98374 | 2010-07-27 |
| 1326368135 | Matt Karl Jahns | Massage Therapist | 2402 20th St Se, Puyallup, WA 98374 | 2010-06-03 |
| 1982833208 | Roxy Sturgeon | Speech-Language Pathologist | 2309 43rd Ave Se, Puyallup, WA 98374 | 2009-07-08 |
| 1497921191 | Morgan Counseling Services Inc. | Substance Abuse Rehabilitation Facility | 10312 120th Street East, Suite #3, Puyallup, WA 98374 | 2008-05-02 |
| 1700055795 | Walter Royal Patterson Jr. | Registered Nurse | 11102 Sunrise Blvd. E., Ste. 103, Woodcreek Healthcare, Puyallup, WA 98374 | 2008-02-25 |
| Find all providers in zip 98374 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891119129 | Lance Alfred Nethercott | Podiatrist | 2728 E Main Ste A, Puyallup, WA 98372-3198 | 2014-02-06 |
| 1679751135 | Kenneth Hilliard Dpm | Podiatrist | 1011 East Main, Suite 101, Puyallup, WA 98372-6768 | 2008-02-07 |
| 1851358436 | Tyler Alden Scheinost | Podiatrist | 324 E Pioneer, Puyallup, WA 98372-3264 | 2006-04-27 |
| 1801312442 | Cmhpod Pllc | Podiatrist | 8012 112th Street Ct E Ste 120, Puyallup, WA 98373-7856 | 2017-08-15 |
| 1124203963 | Puget Sound Specialty Physicians Pllc | Podiatrist | 2728 E Main Ave, Suite A, Puyallup, WA 98372-3198 | 2007-12-28 |
| 1326229485 | Dpmleonheartprwa LLC | Podiatrist | 10116 116th St E, Suite 103, Puyallup, WA 98373-3543 | 2007-11-16 |
| 1790966851 | Dpmsaltonprwa LLC | Podiatrist | 11201 88th Ave E, Suite 210, Puyallup, WA 98373-3802 | 2007-11-16 |
| 1588843254 | Puget Sound Specialty Physicians Pllc | Podiatrist | 2728 E Main Ave, Suite A, Puyallup, WA 98372-3198 | 2007-10-30 |
| 1235170515 | Bruce Micheal Worthen | Podiatrist | 120 14th Ave Se, Suite B, Puyallup, WA 98372-3718 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598392599 | Northern Cascades Foot and Ankle, LLC | Podiatrist | 532 E. Woodin Ave, Chelan, WA 98816-1852 | 2020-03-27 |
| 1801433784 | South Hill Foot & Ankle Clinic Ps | Podiatrist | 3707 S Grand Blvd Ste A, Spokane, WA 99203-2762 | 2019-12-10 |
| 1679025902 | Fasa Family Wellness, Pllc | Podiatrist | 2964 Limited Ln Nw, Suite B, Olympia, WA 98502-4577 | 2016-11-03 |
| 1356899363 | Emily Wagler | Podiatrist | 34509 9th Ave S Ste 303, Federal Way, WA 98003-8709 | 2016-09-19 |
| 1821546540 | Ata Podiatric and Integrative Medicine, Pllc | Podiatrist | 1950 Alaskan Way, Apt 526, Seattle, WA 98101-1075 | 2016-09-12 |
| 1376998179 | Hyowon Choi | Podiatrist | 2075 Barkley Blvd Ste 220, Bellingham, WA 98226 | 2016-04-28 |
| 1407210479 | Philip Matthew Woods | Podiatrist | 1812 N 13th Loop Rd # 1, Shelton, WA 98584-2169 | 2016-04-06 |
| 1063897916 | Yan Rong Cullen | Podiatrist | 13030 121st Way Ne Ste 204, Kirkland, WA 98034-3008 | 2015-07-21 |
| 1972982023 | Brittany Lynn Logan | Podiatrist | 10049 Kitsap Mall Blvd Nw Ste 109, Silverdale, WA 98383-8901 | 2015-05-21 |
| 1093194425 | Silas Klaver | Podiatrist | 1607 Creekside Loop Ste 140, Yakima, WA 98902 | 2015-05-18 |
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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.