Evergreen Children's Clinic, Pllc
Pediatric Adolescent Medicine
Evergreen Children's Clinic, Pllc is a Puyallup, Washington based Pediatric center with medical specialization in
Pediatric Adolescent Medicine. Evergreen Children's Clinic, Pllc is also known as
Pediatrics Pm.
It is located at
1910 S Meridian, Suite A, Puyallup, Washington - 98371-7531. They can be contacted on phone at
253-848-2303 and fax number 253-848-8956.
NPI number (Unique professional ID) for Evergreen Children's Clinic, Pllc is
1568527539 which was assigned by NPPES on 27 Dec, 2006 and it was last updated on 22 Aug, 2020.
Evergreen Children's Clinic, Pllc 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.
Complete Profile:
Evergreen Children's Clinic, Pllc basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
|---|
| Provider Name : | Evergreen Children's Clinic, Pllc |
|---|
| Other Name : | Pediatrics Pm |
|---|
Business Address:
Evergreen Children's Clinic, Pllc address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 1910 S Meridian, Suite A
Puyallup, WA, 98371-7531
United States |
|---|
| Phone Number : | 253-848-2303 |
|---|
| Fax Number : | 253-848-8956 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1568527539 |
|---|
| NPI Entity Type : | Organization |
|---|
| First Enrolment Date : | 27 Dec, 2006 |
|---|
| Last Updated On : | 22 Aug, 2020 |
|---|
Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Susannei Roach |
|---|
| Official Title or Position : | OFFICE MANAGER |
|---|
| Phone Number : | 253-848-2303 |
|---|
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Evergreen Children's Clinic, Pllc are as mentioned. Primary taxonomy code for Evergreen Children's Clinic, Pllc is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Evergreen Children's Clinic, Pllc such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 7054364 | MEDICAID | WA | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 1910 S Meridian, Suite A
Puyallup, WA, 98371-7531
United States |
|---|
| Phone Number : | 253-848-2303 |
|---|
| Fax Number : | 253-848-8956 |
|---|
Business Location:
Patients can refer following map for directions to
Evergreen Children's Clinic, Pllc practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.