Organization Active NPI

Puyallup Valley Women's Clinic, Inc.,P.S.

  • Obstetrics & Gynecology Physician
  • Puyallup, WA
National Provider Identifier
1215194576
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
14802 Issued in WA
Legal business name
PUYALLUP VALLEY WOMEN'S CLINIC, INC.,P.S.
Practice address
520 14TH Ave SE
Puyallup, WA 98372-4683
Phone
(253) 845-1962
Fax
(253) 770-8640
NPI assigned
May 22, 2008
Last updated
May 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Authorized official

Name
Dr. Bruce D. Romig, M.D.NPI 1457406761
Title
Owner
Phone
(253) 845-1962

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 14802 WA Primary

Addresses

Primary practice location

520 14TH Ave SE
Puyallup, WA 98372-4683

Mailing address

520 14TH Ave SE
Puyallup, WA 98372-4683
Phone (253) 845-1962

Other identifiers 1

IdentifierTypeStateIssuer
7113608MedicaidWA

National Provider Directory

National Provider Directory

Locations

1420 3rd St SE
Ste 202
Puyallup, WA 98372
Phone (253) 256-4818

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1215194576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 14TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983724683",
            "telephone_number": "253-845-1962",
            "fax_number": "253-770-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 14TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983724683",
            "telephone_number": "253-845-1962",
            "fax_number": "253-770-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUYALLUP VALLEY WOMEN'S CLINIC, INC.,P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "ROMIG",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-845-1962",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "14802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7113608",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.