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PACIFIC PEDIATRICS NPI 1699936898


NPI Information

NPI: 1699936898
Provider Name: PACIFIC PEDIATRICS
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 50D0947905

Address:
11601 PACIFIC AVE S
TACOMA, WA
ZIP 98444
Phone: (253) 536-3336
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PACIFIC PEDIATRICS is a pediatrics in Tacoma, 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. PACIFIC PEDIATRICS NPI is 1699936898. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11601 PACIFIC AVE S
TACOMA, WA
ZIP 98444-425
Phone: (253) 536-3336
Fax: (253) 536-3242

The provider's authorized official is Nicholas James Themelis .
The authorized official title is Owner and has the following contact phone number (253) 536-3336.

The CLIA number assigned to this NPI record is 50D0947905 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/19/2008 and was last updated on 6/24/2010.


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
1208000000XPediatricsMD00025303WASHINGTONYes

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
11018430MEDICAIDWASHINGTON
2TH0534OTHERWASHINGTONREGENCE BLUESHIELD
3G14451MEDICARE UPINWASHINGTON

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: 4/28/2024

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