Organization
RAINIER PEDIATRICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL L PEARSON M.D. (PRESIDENT/OWNER)
(253) 732-5508
Entity
Organization
Contact information
Practice address
12904 94TH AVE E, PUYALLUP, WA 98373-5538
(253) 841-3999
(253) 841-7311
Mailing address
12904 94TH AVE E, PUYALLUP, WA 98373-5538
(253) 841-3999
(253) 841-7311
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD00014726
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000303437
EHR NLR REGISTRATION NUMBER
WA
05
—
1069103
—
WA
01
—
2080A0000X
TAXONOMY CODE
—
01
—
601845065
UBI
WA
Enumeration date
05/05/2014
Last updated
05/05/2014
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