Active NPI
Pine Family Inc
- Physician Assistant
- Sunnyside, WA
National Provider Identifier
1205393287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Legal business name
- PINE FAMILY INC
- Practice address
- 2240 E Lincoln Ave
Sunnyside, WA 98944-2487 - Phone
- (509) 836-2367
- NPI assigned
- Feb 26, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary Lou Pine, PAC
- Title
- Owner/Provider
- Phone
- (509) 836-2367
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
2240 E Lincoln Ave
Sunnyside, WA 98944-2487
Mailing address
203 SW Malibu Dr
Prosser, WA 99350-9419
Phone (509) 836-2367
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2109936 | Medicaid | WA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551139200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1551139200000",
"number": "1205393287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "203 SW MALIBU DR",
"city": "PROSSER",
"state": "WA",
"postal_code": "993509419",
"telephone_number": "509-836-2367",
"fax_number": "855-784-6425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2240 E LINCOLN AVE",
"city": "SUNNYSIDE",
"state": "WA",
"postal_code": "989442487",
"telephone_number": "509-836-2367"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PINE FAMILY INC",
"organizational_subpart": "NO",
"enumeration_date": "2019-02-26",
"last_updated": "2019-02-26",
"status": "A",
"authorized_official_last_name": "PINE",
"authorized_official_first_name": "MARY",
"authorized_official_middle_name": "LOU",
"authorized_official_title_or_position": "OWNER/PROVIDER",
"authorized_official_telephone_number": "509-836-2367",
"authorized_official_credential": "PAC"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2109936",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sunnyside, WA
- Patrick J Corbett P S
- Maria DJ Perez
- Ramon Perez Jr., PA-C
- Kaylan Sainath Phillips, OD
- Ana L Piliado Alfaro
- Pine Family Pharmacy LLC (Doctor's Pharmacy)
- Pine Family Practice LLC
- Mary Lou Pine, PA-C
- Pioneer Specialty Services, PLLC
- Planned Parenthood of Greater Washington & North Idaho (PPGWNI Sunnyside Health Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.