Organization
PEDIATRIC HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAZEN DAHAN M.D. (MANGER)
(253) 848-7660
Entity
Organization
Contact information
Practice address
120 14TH AVE SE STE A, PUYALLUP, WA 98372-3718
(253) 848-7660
(253) 841-1801
Mailing address
120 14TH AVE SE STE A, PUYALLUP, WA 98372-3718
(253) 848-7660
(253) 841-1801
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
025209 MD00038984
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1115435
—
WA
Enumeration date
06/13/2008
Last updated
06/13/2008
About Stedi
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