| South Hill Family Medicine Pc | |
|
3908 10th St Se Puyallup WA 98374-2188 | |
| (253) 848-5951 | |
| (253) 864-8954 |
| Full Name | South Hill Family Medicine Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 3908 10th St Se, Puyallup, Washington |
| Authorized Official Name and Position | Rhiannon Brovold (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 2538485951 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Hill Family Medicine Pc 3908 10th St Se Puyallup WA 98374-2188 Ph: (253) 848-5951 | South Hill Family Medicine Pc 3908 10th St Se Puyallup WA 98374-2188 Ph: (253) 848-5951 |
| NPI Number | 1538253331 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 06/06/2023 |
| Medicare PECOS PAC ID | 8729980396 |
|---|---|
| Medicare Enrollment ID | O20040123000443 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538253331 | NPI | - | NPPES |
| 0169201 | Other | WA | L& I GROUP NUMBER |
| 7036114 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 601290482 (Washington) | Primary |
| Provider Name | Marc L Aversa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447291984 PECOS PAC ID: 6901708585 Enrollment ID: I20040203000837 |
| Provider Name | David A Judish |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1720030802 PECOS PAC ID: 8426040056 Enrollment ID: I20040406001629 |
| Provider Name | Cynthia L Desmond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245220003 PECOS PAC ID: 9032104070 Enrollment ID: I20040419000531 |
| Provider Name | James T Majors |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285674341 PECOS PAC ID: 4486541315 Enrollment ID: I20040514000366 |
| 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 | Donald L Sinden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316922735 PECOS PAC ID: 3274435854 Enrollment ID: I20050728001275 |
| Provider Name | Carey Morrill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912098914 PECOS PAC ID: 9436163342 Enrollment ID: I20060131000312 |
| Provider Name | Mary E Cyr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447382601 PECOS PAC ID: 6204842487 Enrollment ID: I20060224000461 |
| Provider Name | Darin G Blackburn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629011010 PECOS PAC ID: 6204846579 Enrollment ID: I20060501000725 |
| Provider Name | Neena Chawla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831314731 PECOS PAC ID: 1658477427 Enrollment ID: I20070511000134 |
| Provider Name | Stacy L Merrifield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497967103 PECOS PAC ID: 6800987264 Enrollment ID: I20070814000628 |
| Provider Name | Julie A Komarow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295757862 PECOS PAC ID: 8022000611 Enrollment ID: I20080521000454 |
| Provider Name | Daniel W Wells |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548340375 PECOS PAC ID: 8022017706 Enrollment ID: I20080718000389 |
| Provider Name | Teresa A Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366613960 PECOS PAC ID: 9739258666 Enrollment ID: I20080820000110 |
| Provider Name | Heather D Hokanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417109844 PECOS PAC ID: 9931248630 Enrollment ID: I20091208000801 |
| Provider Name | Sean S Stout |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316925498 PECOS PAC ID: 3577691740 Enrollment ID: I20100507000745 |
| Provider Name | Nancy A Grubb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538101795 PECOS PAC ID: 8820990401 Enrollment ID: I20100510000229 |
| Provider Name | Susan E Mcdonald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740343995 PECOS PAC ID: 5294864153 Enrollment ID: I20100602000587 |
| Provider Name | Kevin W Taggart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588727846 PECOS PAC ID: 7719889393 Enrollment ID: I20100602000850 |
| Provider Name | Jerry Fred Duris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760540215 PECOS PAC ID: 9436282589 Enrollment ID: I20100727000452 |
| Provider Name | Jeremy Wade Van Gieson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265640767 PECOS PAC ID: 2860675113 Enrollment ID: I20110608000504 |
| Provider Name | Jennifer Marie Hrivnak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740531086 PECOS PAC ID: 8022261940 Enrollment ID: I20121228000493 |
| Provider Name | Jennifer N Pense |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053605600 PECOS PAC ID: 6800016684 Enrollment ID: I20140929001837 |
| Provider Name | John Dinh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538456280 PECOS PAC ID: 9335369628 Enrollment ID: I20150603000540 |
| Provider Name | Blanca Zuniga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336457258 PECOS PAC ID: 5991947384 Enrollment ID: I20150928000939 |
| Provider Name | Kristina R Hansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154846335 PECOS PAC ID: 6800169350 Enrollment ID: I20170905000723 |
| Provider Name | Patricia Ann Solomos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851818280 PECOS PAC ID: 5294092441 Enrollment ID: I20171127002119 |
| Provider Name | Thuy-trang T Hahn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639688302 PECOS PAC ID: 9032476155 Enrollment ID: I20171128002167 |
| Provider Name | Joslyn A Tapec |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639727977 PECOS PAC ID: 6204269632 Enrollment ID: I20191125002846 |
| Provider Name | Mua Ngo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215462833 PECOS PAC ID: 3678845641 Enrollment ID: I20200729000786 |
| Provider Name | Gillian Anne-claire Mcravin-johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578176285 PECOS PAC ID: 2062831639 Enrollment ID: I20200930003320 |
| Provider Name | Hope M Beam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679162267 PECOS PAC ID: 9133535198 Enrollment ID: I20210317001044 |
| Provider Name | Charis Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518317072 PECOS PAC ID: 8325330962 Enrollment ID: I20210405000861 |
| Provider Name | Brandi Jo Boden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023676541 PECOS PAC ID: 3476889692 Enrollment ID: I20220805002574 |
| Provider Name | Kassondra Wagy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629703731 PECOS PAC ID: 5698150035 Enrollment ID: I20220921000401 |
| Provider Name | Chris Olmstead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134817596 PECOS PAC ID: 8527426238 Enrollment ID: I20230627002705 |
| Provider Name | Kiersti Devaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073280277 PECOS PAC ID: 1456710938 Enrollment ID: I20230630000688 |
| Provider Name | Corie Megan King-langin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790480598 PECOS PAC ID: 4587024153 Enrollment ID: I20230713002944 |
| Provider Name | Courtney Dyan Randolph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558071597 PECOS PAC ID: 1759741713 Enrollment ID: I20230721002361 |
| Provider Name | Charles Leighton Hitztaler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235869793 PECOS PAC ID: 2860849601 Enrollment ID: I20231115003116 |
| Provider Name | Elizabeth Abidemi Shoewu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770266140 PECOS PAC ID: 9739539172 Enrollment ID: I20231227000921 |
| Provider Name | Merrily Fillmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447012695 PECOS PAC ID: 7113360694 Enrollment ID: I20240212003534 |
| Provider Name | Jillian Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891564118 PECOS PAC ID: 7911340351 Enrollment ID: I20240213001493 |
| Provider Name | Elisabeth Anne Rasch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770345068 PECOS PAC ID: 6800230954 Enrollment ID: I20240216003624 |
| Provider Name | Kristin Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508620824 PECOS PAC ID: 8921442526 Enrollment ID: I20240222002409 |
| Provider Name | Sereyrath Lim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407618754 PECOS PAC ID: 3779921895 Enrollment ID: I20240409000432 |
| Provider Name | Stephanie Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871109017 PECOS PAC ID: 9830563949 Enrollment ID: I20240917002333 |
Community Health Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 201 W Main, Puyallup, WA 98371 Phone: 253-722-2161 | |
Iora Health Washington Physicians, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3705 S Meridian Ste B, Puyallup, WA 98373 Phone: 888-663-6331 Fax: 415-252-7176 | |
Horizonview Health, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1408 3rd St Se Ste 200, Puyallup, WA 98372 Phone: 253-268-3345 Fax: 253-881-1490 | |
Natural Life Integrative Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 23rd Ave Se, Puyallup, WA 98372 Phone: 253-268-2170 Fax: 253-268-0658 | |
Sound Family Senior Clinic Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3909 10th St Se, Puyallup, WA 98374 Phone: 253-848-5951 | |
Washington Center For Pain Management Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 120 14th Ave Se Ste B, Puyallup, WA 98372 Phone: 425-774-1538 | |
Everside Health, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 615 E Pioneer, Suite 103, Puyallup, WA 98372 Phone: 727-457-8286 |