PUYALLUP CLINIC INC (NPI# 1497874903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497874903 |
| Entity Type | Organization |
| Organization Name | PUYALLUP CLINIC INC |
| Other Organization Name | PUYALLUP CLINIC INC., PS |
| Practice Address |
800 S Meridian Ste A Puyallup WA 98371-6994 |
| Practice Telephone | 2538456645 |
| Practice Fax Number | 2537702295 |
| Mailing Telephone | 2538456645 |
| Mailing Fax Number | 2537702295 |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2019-07-31 |
| Authorized Official Name | JERRY FRED DURIS (PRESIDENT AND CEO) |
| Authorized Official Telephone | 2538456645 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 261Q00000X | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7120363 | 05 |
| Other Name | Type Code |
|---|---|
| Puyallup Clinic Inc., PS | Former Legal Business Name - Organization |
| Street Address |
800 S MERIDIAN STE A |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98371-6994 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396816682 | Consuelo Epistola | Physician Assistant | 800 S Meridian Ste A, Puyallup, WA 98371-6994 | 2006-11-10 |
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194381905 | Washington Center for Pain Management LLC | Clinic/Center | 120 14th Ave Se Ste B, Puyallup, WA 98372-3718 | 2019-05-16 |
| 1760757850 | Kosnoski Eye Care Inc | Clinic/Center | 12511 Meridian E, Puyallup, WA 98373-3425 | 2012-03-21 |
| 1265620751 | Nicole M. Lauer Chiropractic P.a. | Clinic/Center | 2600 S Meridian, Apt 1412, Puyallup, WA 98373-1556 | 2007-10-09 |
| 1821097429 | Puyallup Radiological Assocs, Inc. | Clinic/Center | 800 S Meridian, Suite B, Puyallup, WA 98371-6995 | 2005-07-18 |
| 1528445160 | Rediclinic of Wa, LLC | Clinic/Center | 9502 176th St E, Puyallup, WA 98375-9300 | 2015-05-04 |
| 1598176893 | Merwin Chiropractic Inc | Clinic/Center | 15311 Canyon Rd E, Puyallup, WA 98375-7473 | 2014-05-08 |
| 1982924767 | John L. Diller, Md | Clinic/Center | 610 S Meridian, Puyallup, WA 98371-5908 | 2010-06-03 |
| 1386754661 | Lakes Family Medicine, Ps | Clinic/Center | 10116 116th St E, Suite 101, Puyallup, WA 98373-3543 | 2006-08-30 |
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| 1922621721 | Riaz Pllc | Clinic/Center | 8378 W Grandridge Blvd Ste 110, Kennewick, WA 99336-5401 | 2020-05-27 |
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| 1720617533 | Nova Mind-body LLC | Clinic/Center | 116 13th Ave E Apt 1e, Seattle, WA 98102-6142 | 2020-04-03 |
| 1609403054 | Lavender Luxe Massage | Clinic/Center | 100 3rd St Ste 100, Davenport, WA 99122-5008 | 2020-03-25 |
| 1417582255 | Personalized Health, LLC | Clinic/Center | 7136 Mlk Jr Way S Ste 204, Seattle, WA 98118-3526 | 2020-03-11 |
| 1912530932 | Lummi Indian Business Council | Clinic/Center | 2924 Haxton Way, Bellingham, WA 98226-9265 | 2020-02-18 |
| Find all providers with the same taxonomy | ||||
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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.