Pediatrics Pm

LBN: Evergreen Children'S Clinic, Pllc
Pediatrics Pm is an health care organization with primary practice located at 1910 S Meridian Suite A, Puyallup WA 98371-7531. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as the primary health care specialty. Evergreen Children'S Clinic, Pllc can be contacted via phone (253) 848-2303, or through Roach, Susanne I via phone (253) 848-2303.

Contact Information

Primary practice address
1910 S Meridian Suite A Puyallup WA 98371-7531
Phone: (253) 848-2303
Fax: (253) 848-8956
Website:
Map and Directions
Authorized official contact:
Name: Roach, Susanne I
Phone: (253) 848-2303

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X

Profile Details

NPI number 1568527539
LBN Legal business name Evergreen Children'S Clinic, Pllc
DBA Doing business as Pediatrics Pm
Authorized official Roach, Susanne I
Entity Organization
Organization subpart 1 No
Enumeration date Dec 27th, 2006
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568527539 NPPES
Washington MEDICAID 7054364

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