Pearl Plastic Surgery, PLLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

PEARL PLASTIC SURGERY, PLLC

Practice address

145 Lilly Rd NE Ste 102
Olympia, WA 98506-5028

Phone

(360) 878-9300

Fax

(360) 878-9666

NPI assigned

Aug 22, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Daniel J Albershardt, MDNPI 1295056455

Title

Manager

Phone

(360) 438-6400

Specialties & licenses 5

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel J Albershardt, MD

  • Anesthesiology Physician
  • Olympia, WA
  • NPI 1295056455
  NPD Authorized official
• Caroline Emma Heidbreder, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Tacoma, WA
  • NPI 1487020830
  NPD
• Megan Gray

  • Plastic Surgery Physician
  • Mountlake Terrace, WA
  • NPI 1588197370
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1063245249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 LILLY RD NE STE 102",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065028",
            "telephone_number": "360-878-9300",
            "fax_number": "360-878-9666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 LILLY RD NE STE 102",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065028",
            "telephone_number": "360-878-9300",
            "fax_number": "360-878-9666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8685 Martin Way E Ste 107",
            "address_purpose": "LOCATION",
            "city": "Lacey",
            "state": "WA",
            "postal_code": "985165857",
            "country_code": "US",
            "telephone_number": "360-878-9300",
            "fax_number": "360-878-9666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PEARL PLASTIC SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A",
        "authorized_official_last_name": "ALBERSHARDT",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "360-438-6400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Conley Payne, DDS
• Meg Payne
• Eli Peace
• Melanie Peachman
• Alijandra Alise Peake
• Pearl Plastic Surgery, PLLC
• Dennis F Peck, MD
• Dennis W Peck, MD
• Mark S Peckler, M.D.
• Amber Nichole Pecolatto

• Multi-Specialty Clinic/Center in Olympia, WA
• Providers in Olympia, WA by specialty
• Multi-Specialty Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.