Organization
PUYALLUP CLINIC INC
Active
Other names
Puyallup Clinic Inc., PS
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY FRED DURIS MD (PRESIDENT AND CEO)
(253) 845-6645
Entity
Organization
Contact information
Practice address
800 S MERIDIAN STE A, PUYALLUP, WA 98371-6994
(253) 845-6645
(253) 770-2295
Mailing address
800 S MERIDIAN STE A, PUYALLUP, WA 98371-6994
(253) 845-6645
(253) 770-2295
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
261Q00000X
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7120363
—
WA
Enumeration date
03/28/2007
Last updated
07/31/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up