| Puyallup Tribal Health Authority | |
|
2209 E 32nd St Tacoma WA 98404 | |
| (253) 593-0232 | |
| (253) 382-2091 |
| Full Name | Puyallup Tribal Health Authority |
|---|---|
| Speciality | Clinic/Center |
| Location | 2209 E 32nd St, Tacoma, Washington |
| Authorized Official Name and Position | Chris Henry (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2535930232 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Puyallup Tribal Health Authority 2209 E 32nd St P.o. Box 8009 Tacoma WA 98404-4922 Ph: (253) 593-0232 | Puyallup Tribal Health Authority 2209 E 32nd St Tacoma WA 98404 Ph: (253) 593-0232 |
| NPI Number | 1063455665 |
|---|---|
| Provider Enumeration Date | 06/13/2006 |
| Last Update Date | 07/13/2018 |
| Medicare PECOS PAC ID | 9436047537 |
|---|---|
| Medicare Enrollment ID | O20040309001482 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063455665 | NPI | - | NPPES |
| PO1874 | Other | WA | REGENCE CLINIC ID |
| 366486001 | Other | WA | GROUP HEALTH OPTIONS-CLIN |
| 7090954 | Medicaid | WA | |
| 0042440 | Other | WA | LABOR & INDUSTRIES CLINIC |
| 7013220 | Medicaid | WA | |
| 5035233 | Medicaid | WA | |
| 366486001 | Other | WA | GROUP HEALTH OPTIONS-CD |
| Provider Name | Theresa M Maresca |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932177664 PECOS PAC ID: 9234127945 Enrollment ID: I20040503000807 |
| Provider Name | Walter B Hollow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316914716 PECOS PAC ID: 5890776728 Enrollment ID: I20040526001627 |
| Provider Name | Esther M Park-hwang |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184638439 PECOS PAC ID: 5698759488 Enrollment ID: I20040617001212 |
| Provider Name | Terry J0 Felts |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1740263888 PECOS PAC ID: 7911984398 Enrollment ID: I20040702000664 |
| Provider Name | Gail L Fulton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992748024 PECOS PAC ID: 7012996432 Enrollment ID: I20040719000345 |
| Provider Name | Paul R Barnett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902840838 PECOS PAC ID: 3577533173 Enrollment ID: I20040730000061 |
| Provider Name | Arthur R Knodel |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1619960523 PECOS PAC ID: 1153313283 Enrollment ID: I20040816001049 |
| Provider Name | Lise K Alexander |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114020310 PECOS PAC ID: 8628077013 Enrollment ID: I20061213000013 |
| Provider Name | Mark A Hoover |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154361335 PECOS PAC ID: 6305759168 Enrollment ID: I20080117000269 |
| Provider Name | Michelle R Show |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184844946 PECOS PAC ID: 2769559483 Enrollment ID: I20080923000201 |
| Provider Name | Anne P Mccormack |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1457417115 PECOS PAC ID: 8123157294 Enrollment ID: I20100527000737 |
| Provider Name | Stephen G Cook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427078542 PECOS PAC ID: 7719001064 Enrollment ID: I20100824000626 |
| Provider Name | Margaret Johnston Kitazawa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841220183 PECOS PAC ID: 2961526330 Enrollment ID: I20100908000272 |
| Provider Name | Mark H Kozakowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700829140 PECOS PAC ID: 6507059763 Enrollment ID: I20101020000316 |
| Provider Name | Alan E Shelton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174561757 PECOS PAC ID: 8729272232 Enrollment ID: I20101028001070 |
| Provider Name | Kyle E Ferguson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164739058 PECOS PAC ID: 7911179239 Enrollment ID: I20111011000242 |
| Provider Name | Kris A Peterson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932284460 PECOS PAC ID: 9234368366 Enrollment ID: I20140212000539 |
| Provider Name | William T Chythlook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467676155 PECOS PAC ID: 3577654912 Enrollment ID: I20140813002962 |
| Provider Name | Aaron T Rhyner |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1619232410 PECOS PAC ID: 9335451533 Enrollment ID: I20151104000872 |
| Provider Name | Socia Nicole Love-thurman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356787451 PECOS PAC ID: 7517288772 Enrollment ID: I20160708000718 |
| Provider Name | Austin G Shelton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811334816 PECOS PAC ID: 6406177823 Enrollment ID: I20161019001574 |
| Provider Name | Brian R Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518222371 PECOS PAC ID: 1153600549 Enrollment ID: I20161107001634 |
| Provider Name | Mary Elizabeth Q Platt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1972983146 PECOS PAC ID: 7012225261 Enrollment ID: I20181025002115 |
| Provider Name | Mikaela M Alger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013302330 PECOS PAC ID: 8022324029 Enrollment ID: I20190202000252 |
| Provider Name | Laramie V Lunday |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184075988 PECOS PAC ID: 4789970914 Enrollment ID: I20191021001662 |
| Provider Name | Mariam Savabi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225424062 PECOS PAC ID: 0446564702 Enrollment ID: I20191107001740 |
| Provider Name | Amy Marie Chabitnoy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396108957 PECOS PAC ID: 4385078039 Enrollment ID: I20200106000801 |
| Provider Name | Martina L Tam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255862983 PECOS PAC ID: 2062780166 Enrollment ID: I20200111000019 |
| Provider Name | Muna I Osman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578031266 PECOS PAC ID: 0840627451 Enrollment ID: I20200220001197 |
| Provider Name | Traci Boyd Acklin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578527107 PECOS PAC ID: 4587094131 Enrollment ID: I20200526000491 |
| Provider Name | James Joseph Hooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376070904 PECOS PAC ID: 4880965847 Enrollment ID: I20200721004444 |
| Provider Name | Kelsey K Motanic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083146856 PECOS PAC ID: 7315216819 Enrollment ID: I20200817001299 |
| Provider Name | Candis Leshawn Halsted |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255005898 PECOS PAC ID: 5698163699 Enrollment ID: I20211025001472 |
| Provider Name | Erica Tasi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235547522 PECOS PAC ID: 8426348335 Enrollment ID: I20211108001280 |
| Provider Name | Jacqueline I Potts |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316438161 PECOS PAC ID: 5294110839 Enrollment ID: I20220916002510 |
| Provider Name | Mitchell R Kamake'eaina-ornelas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538621412 PECOS PAC ID: 4880920453 Enrollment ID: I20220930002726 |
| Provider Name | Nichole M Thorsvik |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1700266798 PECOS PAC ID: 6608125240 Enrollment ID: I20221209002486 |
| Provider Name | Angelo R Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164962312 PECOS PAC ID: 8729315239 Enrollment ID: I20230323002299 |
| Provider Name | Laurisa M Rodrigues |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821585985 PECOS PAC ID: 4587082151 Enrollment ID: I20230626000932 |
| Provider Name | Alexis Lee Brendible |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770111528 PECOS PAC ID: 7618390501 Enrollment ID: I20230707001612 |
| Provider Name | Ashley M Napoleon |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1851005474 PECOS PAC ID: 4688033590 Enrollment ID: I20230710001683 |
| Provider Name | Rachel L Snodgrass |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1437767001 PECOS PAC ID: 7012367410 Enrollment ID: I20231227002880 |
| Provider Name | Jennifer A Decoteau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417016056 PECOS PAC ID: 1456701861 Enrollment ID: I20231227003384 |
| Provider Name | Sarah L Bennett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003098682 PECOS PAC ID: 2163872433 Enrollment ID: I20231228002384 |
| Provider Name | Selma A Suzuki |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1811202732 PECOS PAC ID: 5799135075 Enrollment ID: I20231228002867 |
| Provider Name | Kaye G Lunsford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013601178 PECOS PAC ID: 4082065073 Enrollment ID: I20240103003315 |
| Provider Name | Thong Pham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548670706 PECOS PAC ID: 6305297391 Enrollment ID: I20240103003454 |
| Provider Name | Michele M Yoder |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1609813245 PECOS PAC ID: 1658722657 Enrollment ID: I20240103003896 |
| Provider Name | Kerry A Shaughnessy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740826593 PECOS PAC ID: 7517301203 Enrollment ID: I20240221002788 |
| Provider Name | Nevin Mcspadden |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417284134 PECOS PAC ID: 7416393285 Enrollment ID: I20240314003971 |
| Provider Name | Ruth A Amarok |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134697964 PECOS PAC ID: 2567809635 Enrollment ID: I20240325002630 |
| Provider Name | Bradley A Cotter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376961763 PECOS PAC ID: 6204273063 Enrollment ID: I20240328001785 |
| Provider Name | Susannah S Misiaszek |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063702678 PECOS PAC ID: 6204275522 Enrollment ID: I20240419001471 |
| Provider Name | Nicholas A Berretta |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1235796376 PECOS PAC ID: 8729520309 Enrollment ID: I20240611002011 |
| Provider Name | Olivia M Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730848698 PECOS PAC ID: 7214472943 Enrollment ID: I20240717002428 |
| Provider Name | Max P Castanera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548847841 PECOS PAC ID: 9638577794 Enrollment ID: I20240808003122 |
| Provider Name | Tyrone L Kellewood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811123136 PECOS PAC ID: 1557582772 Enrollment ID: I20240813002408 |
| Provider Name | Patricia A Mahaulu-stephens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831840438 PECOS PAC ID: 1355875808 Enrollment ID: I20241107000014 |
| Provider Name | Christina M Jarchow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851794887 PECOS PAC ID: 7416487061 Enrollment ID: I20250211003652 |
Olympic Dental & Denture Center, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3720 6th Ave, Suite A, Tacoma, WA 98406 Phone: 253-752-1320 Fax: 253-752-1425 | |
Berg Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3610 S 17th St, Tacoma, WA 98405 Phone: 253-572-3383 Fax: 253-572-8712 | |
Duke N Bui, Dds, Ps Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5631 Tacoma Mall Blvd Ste 5, Tacoma, WA 98409 Phone: 253-475-7125 | |
Pacific Northwest Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2702 S 42nd St Ste 106, Tacoma, WA 98409 Phone: 253-472-7788 Fax: 253-474-9253 | |
Bansuk Ju Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2302 S Union Ave Ste A6, Tacoma, WA 98405 Phone: 253-752-4422 | |
Arnell Prato, D.d.s., P.l.l.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4125 49th Ave Ne Ste D, Tacoma, WA 98422 Phone: 253-952-2200 | |
Community Health Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3811 E Arlington Dr Rm 117, Tacoma, WA 98404 Phone: 253-597-4550 |