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PEDIATRIC HEALTH CARE
NPI 1689116691
Nurse Practitioner - Pediatrics in Puyallup, WA

Active since November 08, 2016CLIA 50D0998892 · Certificate of Compliance
1420 3RD ST SE, STE. 200, PUYALLUP, WA 98372(253) 848-7660(253) 841-1801 Get Directions Write a Review

NPPES record last updated: November 8, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pediatric Health Care NPPES

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

PEDIATRIC HEALTH CARE (NPI 1689116691) is a healthcare organization registered as a pediatrics in Puyallup, Washington and active in the NPI registry since November 2016. The organization holds a CLIA Certificate of Compliance certificate valid through April 4, 2028 and lists Mazen Dahan, F.a.a.p., as its authorized official.

NPPES Registry Identity

NPI1689116691
Entity TypeOrganization
Primary Taxonomy363LP0200X
Legal Business NamePEDIATRIC HEALTH CARE
Location Address1420 3RD ST SE, STE. 200Puyallup, WA 98372-3730
Mailing Address1420 3rd St Se, Ste. 200Puyallup, WA 98372-3730 · (253) 848-7660 · Fax (253) 841-1801
Phone(253) 848-7660
Fax(253) 841-1801
Organization SubpartNo
Authorized OfficialMazen DahanF.a.a.p. · (253) 848-7660
Enumeration DateNovember 8, 2016
✔ NPI 1689116691 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in WA · 60705836
1420 3RD ST SE, Puyallup, WA 98372
Open in Google Maps ↗

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

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 Compliance 50D0998892

Pediatric Health Care · Puyallup, WA
Active · expires Apr 4, 2028
CLIA Number50D0998892
Laboratory TypePhysician Office
Certificate Effective DateFebruary 13, 2012
Certificate Expiration DateApril 4, 2028
Laboratory DirectorMazen Dahan
Laboratory Phone(253) 848-7660
Laboratory LocationPediatric Health Care1420 3rd St SE Ste 200, Puyallup, WA 98372
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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.

DR. TYLER TRUDEAU DPT
Physical Therapist
1420 3RD ST SE, STE. 102
PUYALLUP, WA 98372
Pierce County (253) 770-1807
ANDREA M FONNER, DDS
Dentist (Dentist Anesthesiologist)
1420 3RD ST SE
PUYALLUP, WA 98372
Pierce County (206) 579-5163
SCOTT JOHN SOEDER LCO
Orthotist
1420 3RD ST SE, SUITE 108
PUYALLUP, WA 98372
Pierce County (253) 840-0227
CHELL ANTOINETTE LITTLE LMP
Massage Therapist
1420 3RD ST SE, SUITE 102
PUYALLUP, WA 98372
Pierce County (253) 770-1807

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 Pediatric Health Care's NPI number?

The NPI number for Pediatric Health Care is 1689116691. It was assigned to this organization in the NPPES registry on November 8, 2016.

Where is Pediatric Health Care located?

Pediatric Health Care is located at 1420 3rd St SE Ste. 200, Puyallup, WA 98372. The listed phone number is (253) 848-7660.

What is Pediatric Health Care's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Does Pediatric Health Care hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 50D0998892) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pediatric Health Care was last updated on November 8, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.