Organization
MULTICARE HEALTH SYSTEM
Active
Other names
Pediatrics Northwest by Mary Bridge Children's
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY E WILLIAMS (MANAGER, PROVIDER DATA & ENROLLMENT)
(253) 459-8009
Entity
Organization
Contact information
Practice address
505 S 336TH ST # 210, FEDERAL WAY, WA 98003-5947
(253) 383-5777
(253) 383-5320
Mailing address
315 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4234
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2080P0201X
Pediatric Allergy/Immunology Physician
—
—
2080P0207X
Pediatric Hematology & Oncology Physician
—
—
2080P0214X
Pediatric Pulmonology Physician
—
—
2080S0012X
Pediatric Sleep Medicine Physician
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
07/16/2019
Last updated
10/22/2019
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