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THE IDA KARLIN PEDIATRIC CENTER NPI 1366657918


NPI Information

NPI: 1366657918
Provider Name: THE IDA KARLIN PEDIATRIC CENTER
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
319 5TH ST SW
PUYALLUP, WA
ZIP 98371
Phone: (253) 848-0351
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THE IDA KARLIN PEDIATRIC CENTER is a pediatrics in Puyallup, WA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. THE IDA KARLIN PEDIATRIC CENTER NPI is 1366657918. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

319 5TH ST SW
PUYALLUP, WA
ZIP 98371-828
Phone: (253) 848-0351
Fax: (253) 841-1397

The provider's authorized official is Ovidio Penalver .
The authorized official title is Corporate Officer, Provider and has the following contact phone number (253) 848-0351.

The enumeration date for this NPI number is 5/14/2007 and was last updated on 12/23/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorLH60394287WASHINGTONNo
2363LP0200XNurse PractitionerPediatricsAP60312846WASHINGTONNo
3363LP0808XNurse PractitionerPsychiatric/Mental HealthAP60311598WASHINGTONNo
4103T00000XPsychologistPY60385056WASHINGTONNo
5208000000XPediatricsMD00015660WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17110653MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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