PIONEER FAMILY PRACTICE, PLLC - NPI 1205965365 - Family Medicine in Lacey, WA

Q: What is the provider's specialty?

The provider's specialty is Family Medicine with taxonomy code 207Q00000X.

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About Pioneer Family Practice, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PIONEER FAMILY PRACTICE, PLLC (NPI 1205965365) is a healthcare organization registered as a family medicine in Lacey, Washington and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Diane M Taylor, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1205965365

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NamePIONEER FAMILY PRACTICE, PLLC

Location Address5130 CORPORATE CENTER CT SELacey, WA 98503-5957

Mailing Address5130 Corporate Center Ct SeLacey, WA 98503-5957 · (360) 413-8600 · Fax (360) 413-8822

Phone(360) 413-8600

Fax(360) 413-8822

Organization SubpartNo

Authorized OfficialDiane M TaylorBusiness Manager · (360) 413-8617

Enumeration DateMarch 5, 2007

Last NPPES UpdateMarch 7, 2023

✔ NPI 1205965365 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

5130 CORPORATE CENTER CT SE, Lacey, WA 98503

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Other Identifiers 4

Other147741WA · Labor And Inudustry

Medicaid7105869WA

Other02WA · Corporate

Other1205965365WA · Npi

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D0993310

Pioneer Family Practice By Multicare · Lacey, WA

Active · expires Apr 4, 2028

CLIA Number50D0993310

Laboratory TypePhysician Office

Certificate Effective DateJune 4, 2021

Certificate Expiration DateApril 4, 2028

Laboratory DirectorCris Johnson

Laboratory Phone(360) 413-8600

Laboratory LocationPioneer Family Practice By Multicare5130 Corporate Center Ct SE, Lacey, WA 98503

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EDWARD DAVID CATES MD

Family Medicine