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Contact Information

PRIME HEALTH CLINIC PLLC
1004 E MAIN STE D
PUYALLUP, WA98372-3199
 Phone: 253-268-0720
 Fax: 253-466-7072
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Gastroenterology

2080P0206X 37 Physician/Pediatric Medicine
 

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for PRIME HEALTH CLINIC PLLC

NPI # 1710306436
LBN Legal business name PRIME HEALTH CLINIC PLLC
Authorized official ABEER ALIDLEBI - (GENERAL MANGER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/09/2014
Last updated 08/29/2021 - About 5 years ago
Identifiers
WA License # 00035982
WA License # 60306063
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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