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CONCORDIA STAR MEDICAL LLC
NPI 1508134792
Clinic/Center - Primary Care in Puyallup, WA

Active since December 02, 2011CLIA 50D2034891 · Microscopy
118 7TH AVE SW, SUITE A, PUYALLUP, WA 98371(253) 579-0067(253) 579-0068 Get Directions Write a Review

NPPES record last updated: May 15, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Concordia Star Medical Llc NPPES

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

CONCORDIA STAR MEDICAL LLC (NPI 1508134792) is a healthcare organization registered as a primary care in Puyallup, Washington and active in the NPI registry since December 2011. The organization holds a CLIA Microscopy certificate valid through April 4, 2028 and lists Ladie Christine Arana-domondon, Owner - Ceo, as its authorized official.

NPPES Registry Identity

NPI1508134792
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameCONCORDIA STAR MEDICAL LLC
Location Address118 7TH AVE SW, SUITE APuyallup, WA 98371-6803
Mailing Address118 7th Ave Sw, Suite APuyallup, WA 98371-6803 · (253) 579-0067 · Fax (253) 579-0068
Phone(253) 579-0067
Fax(253) 579-0068
Organization SubpartNo
Authorized OfficialLadie Christine Arana-domondonOwner - Ceo · (253) 209-9009
Enumeration DateDecember 2, 2011
Last NPPES UpdateMay 15, 2015
✔ NPI 1508134792 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in WA · MD00034362
Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X · License MD00034362 (WA)
Also ListedClinic/Center · Urgent CareTaxonomy 261QU0200X · License MD00034362 (WA)
118 7TH AVE SW, Puyallup, WA 98371
Open in Google Maps ↗

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 for Provider-Performed Microscopy Procedures (PPMP) 50D2034891

Concordia Star Medical · Puyallup, WA
Active · expires Apr 4, 2028
CLIA Number50D2034891
Laboratory TypePhysician Office
Certificate Effective DateJanuary 6, 2012
Certificate Expiration DateApril 4, 2028
Laboratory DirectorLadie Arana-Domondon
Laboratory Phone(253) 579-0067
Laboratory LocationConcordia Star Medical118 7th Ave SW Ste A, Puyallup, WA 98371
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 4

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

JENNIFER D ANDERSON
Nurse Practitioner (Family)
118 7TH AVE SW
PUYALLUP, WA 98371
Pierce County (253) 579-0067
DR. LADIE C ARANA-DOMONDON MD
Internal Medicine
118 7TH AVE SW, SUITE A
PUYALLUP, WA 98371
Pierce County (253) 579-0067
CONCORDIA STAR MEDICAL LLC
Clinic/Center (Primary Care)
118 7TH AVE SW, SUITE A
PUYALLUP, WA 98371
Pierce County (253) 579-0067
KAELIN VINCE CRUZ ARNP
Nurse Practitioner (Family)
118 7TH AVE SW
PUYALLUP, WA 98371
Pierce County (253) 250-3888

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Concordia Star Medical LLC's NPI number?

The NPI number for Concordia Star Medical LLC is 1508134792. It was assigned to this organization in the NPPES registry on December 2, 2011.

Where is Concordia Star Medical LLC located?

Concordia Star Medical LLC is located at 118 7th Ave SW Suite A, Puyallup, WA 98371. The listed phone number is (253) 579-0067.

What is Concordia Star Medical LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Concordia Star Medical LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 50D2034891) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Concordia Star Medical LLC accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Concordia Star Medical LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Concordia Star Medical LLC was last updated on May 15, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.