Organization
WOODCREEK PEDIATRICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAM MATHISON (FINANCE MANAGER)
(253) 446-3226
Entity
Organization
Contact information
Practice address
1706 S MERIDIAN, SUITE 120, PUYALLUP, WA 98371-7516
(253) 848-8797
(253) 845-0100
Mailing address
1706 S MERIDIAN, SUITE 120, PUYALLUP, WA 98371-7516
(253) 848-8797
(253) 845-0100
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
363AM0700X
Medical Physician Assistant
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
02/27/2007
Last updated
03/18/2011
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