RAINIER PEDIATRICS INC NPI 1720498280

NPI Information

  • NPI: 1720498280
  • Provider Name: RAINIER PEDIATRICS, INC
  • Classification: Pediatrics - 2080A0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Organization
  • CLIA Number: 50D0635574
  • Address: 12904 94TH AVE E
    PUYALLUP, WA
    ZIP 98373
  • Phone: (253) 841-3999

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NPI Details

RAINIER PEDIATRICS, INC is an adolescent medicine pediatrics in Puyallup, WA. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. RAINIER PEDIATRICS, INC NPI is 1720498280. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

12904 94TH AVE E
PUYALLUP, WA
ZIP 98373-538
Phone: (253) 841-3999
Fax: (253) 841-7311

The provider's authorized official is Michael L Pearson .
The authorized official title is President/owner and has the following contact phone number (253) 732-5508.

The CLIA number assigned to this NPI record is 50D0635574 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/5/2014 and was last updated on 5/5/2014.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080A0000XPediatricsAdolescent MedicineMD00014726WASHINGTONYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11000303437OTHERWASHINGTONEHR NLR REGISTRATION NUMBER
21069103MEDICAIDWASHINGTON
3601845065OTHERWASHINGTONUBI
42080A0000XOTHERTAXONOMY CODE

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: 11/21/2025

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