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PEDIATRICS PM
NPI 1750639704
Nurse Practitioner - Pediatrics in Puyallup, WA

Active since August 23, 2012
1910 MERIDIAN ST S, SUITE A, PUYALLUP, WA 98371(253) 848-2303(253) 848-8956 Get Directions Write a Review

NPPES record last updated: August 23, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Pediatrics Pm NPPES

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

PEDIATRICS PM (NPI 1750639704) is a healthcare organization registered as a pediatrics in Puyallup, Washington and active in the NPI registry since August 2012. The organization lists Susanne I Roach, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1750639704
Entity TypeOrganization
Primary Taxonomy363LP0200X
Legal Business NameEVERGREEN CHILDREN'S CLINIC
Location Address1910 MERIDIAN ST S, SUITE APuyallup, WA 98371-7531
Mailing Address1910 Meridian St S, Suite APuyallup, WA 98371-7531 · (253) 848-2303 · Fax (253) 848-8956
Phone(253) 848-2303
Fax(253) 848-8956
Organization SubpartNo
Authorized OfficialSusanne I RoachOffice Manager · (253) 848-2303
Enumeration DateAugust 23, 2012
✔ NPI 1750639704 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 · AP60305667
1910 MERIDIAN ST S, Puyallup, WA 98371
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Other Names 1

Other NamePediatrics Pm

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

Other Providers at the Same Location NPPES

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

ROSELYNN WEE SIM CUENCA M.D., M.P.H.
Pediatrics
1910 MERIDIAN ST S, STE A
PUYALLUP, WA 98371
Pierce County (253) 848-2303

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 Evergreen Children's Clinic's NPI number?

The NPI number for Evergreen Children's Clinic is 1750639704. It was assigned to this organization in the NPPES registry on August 23, 2012. The provider is also known as Pediatrics Pm.

Where is Evergreen Children's Clinic located?

Evergreen Children's Clinic is located at 1910 Meridian St S Suite A, Puyallup, WA 98371. The listed phone number is (253) 848-2303.

What is Evergreen Children's Clinic's specialty?

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

When was this NPI record last updated?

The NPPES record for Evergreen Children's Clinic was last updated on August 23, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.