EVERGREEN CHILDREN'S CLINIC


Address: 1910 Meridian St S, Suite A, Puyallup, WA 98371-7531
Phone: 2538482303

EVERGREEN CHILDREN'S CLINIC (NPI# 1750639704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1750639704
Entity Type Organization
Organization Name EVERGREEN CHILDREN'S CLINIC
Other Organization Name PEDIATRICS PM
Practice Address 1910 Meridian St S
Suite A
Puyallup
WA 98371-7531
Practice Telephone 2538482303
Practice Fax Number 2538488956
Mailing Telephone 2538482303
Mailing Fax Number 2538488956
Enumeration Date 2012-08-23
Last Update Date 2012-08-23
Authorized Official Name MRS. SUSANNE I ROACH (OFFICE MANAGER)
Authorized Official Telephone 2538482303
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
AP60305667 WA Physician Assistants & Advanced Practice Nursing Providers

Other Provider/Organization Names

Other Name Type Code
Pediatrics PM Other Name - Individual/Organization

Office Location

Street Address 1910 MERIDIAN ST S
SUITE A
City PUYALLUP
State WA
Zip Code 98371-7531

Providers in the same location

NPI Name Taxonomy Address Enumeration
1366428369 Roselynn Wee Sim Cuenca Pediatrics 1910 Meridian St S, Ste A, Puyallup, WA 98371-7531 2005-12-21

Providers in the same zip code

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 Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1336260280 Roberta Louise Salveson Nurse Practitioner 319 5th St Nw, Puyallup, WA 98371 2007-04-02
1124105408 Shawna Hood Nurse Practitioner 1706 S Meridian, Suite 120, Puyallup, WA 98371-7516 2006-11-01
1922026178 Theresa J Harris Nurse Practitioner 1706 S Meridian Ste 130, Puyallup, WA 98371-7516 2006-07-17
1467965954 Heather Buzbee Nurse Practitioner 10217 125th Street Ct E, Puyallup, WA 98374-2761 2017-11-07
1073041364 Lisa Ann Oberlander Nurse Practitioner 11102 Sunrise Blvd E Ste 103, Puyallup, WA 98374-8846 2017-05-31
1689116691 Pediatric Health Care Nurse Practitioner 1420 3rd St Se, Ste. 200, Puyallup, WA 98372-3730 2016-11-08
1649712548 Tera L. Johnson Nurse Practitioner 1420 3rd St Se, Ste. 200, Puyallup, WA 98372-3730 2016-11-08
1558716043 Emily Winn Nurse Practitioner 11102 Sunrise Blvd E, Suite 103, Puyallup, WA 98374-8846 2016-05-03
1801293949 Devyn Catherine Cameron Nurse Practitioner 11102 Sunrise Blvd E, Suite 103, Puyallup, WA 98374-8846 2014-12-03
1114280476 Julia Berndt Rapp Nurse Practitioner 10217 125th Street Ct E Fl 2, Puyallup, WA 98374-2761 2012-06-21
Find all providers in PUYALLUP

Competitor

Search similar providers

City PUYALLUP
Zip Code 98371

Improve Information

Please comment or provide details below to improve the information on EVERGREEN CHILDREN'S CLINIC.

Dataset Information

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.

Trending Searches