PRIME HEALTH CLINIC PLLC (NPI# 1710306436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710306436 |
| Entity Type | Organization |
| Organization Name | PRIME HEALTH CLINIC PLLC |
| Practice Address |
1420 3rd St Se Ste 106 Puyallup WA 98372-3730 |
| Mailing Address |
1420 3rd St Se Suite 106 Puyallup WA 98372-3730 |
| Practice Telephone | 2532680720 |
| Practice Fax Number | 2534667072 |
| Mailing Telephone | 2532680720 |
| Mailing Fax Number | 2534667072 |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2018-05-16 |
| Authorized Official Name | MRS. ABEER ADNAN ALIDLEBI (GENERAL MANGER) |
| Authorized Official Telephone | 2537400977 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | 60306063 | WA | Allopathic & Osteopathic Physicians |
| Y | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
00035982 | WA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1802 Yakima Ave Ste 202, Tacoma, WA 984055304 | 2532680720 | 2534667072 |
| 1907 Cooks Hill Rd, Centralia, WA 985319073 | 2532680720 | 2534667072 |
| 5801 Soundview Dr Ste 156, Gig Harbor, WA 983352215 | 2532680720 | 2534667072 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PRIME HEALTH CLINIC PLLC | 1420 3rd St Se, Ste 106, Puyallup, WA 98372-3730 |
| Street Address |
1420 3RD ST SE STE 106 |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98372-3730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194340349 | Miroslava Anatolyevna Onishchenko | Dietitian, Registered | 1420 3rd St Se Ste 106, Puyallup, WA 98372-3730 | 2020-06-13 |
| 1518441443 | Andi Cheng | Nutritionist | 1420 3rd St Se Ste 106, Puyallup, WA 98372-3730 | 2018-09-17 |
| 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 | 2080P0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Gastroenterology |
| A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811284599 | Monica Michelle Zherebtsov | Pediatrics | 101 W 8th Ave Ste 150e, Spokane, WA 99204-2307 | 2011-07-01 |
| 1174595862 | Joseph Gramling | Pediatrics | Bldg. 9040 Fitzsimmons Drive, Madigan Army Medical Center, Dept of Pediatrics, Tacoma, WA 98431-0001 | 2006-02-06 |
| 1154620680 | Fateema Turay Rose | Pediatrics | 4800 Sand Point Way Ne, Mailstop Ob.9.620.1, Seattle, WA 98105 | 2011-03-23 |
| 1205155215 | Hengqi Zheng | Pediatrics | 4800 Sand Point Way Ne, M/s Ob.9.620.1, Seattle, WA 98105-3901 | 2010-06-01 |
| 1457678112 | Providence Physician Services Co | Pediatrics | 105 W 8th Ave, Ste 150e, Spokane, WA 99204-2302 | 2010-04-21 |
| 1821225863 | Rohit Gupta | Pediatrics | 311 S L St, Tacoma, WA 98405-3720 | 2009-06-17 |
| 1073756854 | Jarrad Matthew Scarlett | Pediatrics | 4800 Sand Point Way Ne, M/s W-7830, Seattle, WA 98105-3901 | 2009-04-09 |
| 1912162538 | Lusine Ambartsumyan | Pediatrics | 4800 Sand Point Way Ne, Seattle, WA 98105-3901 | 2008-07-23 |
| 1063602555 | Uma Pisharody | Pediatrics | 1101 Madison St, Suite 800, Seattle, WA 98104-1306 | 2007-07-31 |
| 1396945630 | Dale Young Lee | Pediatrics | 4800 Sand Point Way Ne, M/s Ob.9.620.1, Seattle, WA 98105-3901 | 2007-07-24 |
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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.