NPIMap

Organization Active NPI

South Sound Pediatrics PLLC

  • Pediatrics Physician
  • Olympia, WA
National Provider Identifier
1073684692
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SOUTH SOUND PEDIATRICS PLLC
Practice address
3516 12TH Ave NE
Olympia, WA 98506-5218
Phone
(360) 456-1600
Fax
(360) 456-6504
NPI assigned
Nov 13, 2006
Last updated
Aug 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Authorized official

Name
Dr. Beth Harvey, MDNPI 1548355472
Title
Medical Director/Partner
Phone
(360) 456-1600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X NU
Pediatrics Physician 208000000X WA Primary

Addresses

Primary practice location

3516 12TH Ave NE
Olympia, WA 98506-5218

Mailing address

3516 12TH Ave NE
Olympia, WA 98506-5218
Phone (360) 456-1600

Other identifiers 2

IdentifierTypeStateIssuer
1029486MedicaidWA
7036924MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
South Sound Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754352000000",
    "number": "1073684692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3516 12TH AVE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065218",
            "telephone_number": "360-456-1600",
            "fax_number": "360-456-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3516 12TH AVE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065218",
            "telephone_number": "360-456-1600",
            "fax_number": "360-456-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SOUND PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/PARTNER",
        "authorized_official_telephone_number": "360-456-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029486",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7036924",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.