NPIMap

Organization Active NPI

Pacific Medical Dialysis Services

  • Nephrology Physician
  • Tacoma, WA
National Provider Identifier
1285406249
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
PACIFIC MEDICAL DIALYSIS SERVICES
Practice address
917 Pacific Ave Ste 600
Tacoma, WA 98402-4437
Phone
(253) 310-2236
NPI assigned
Oct 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Authorized official

Name
Charles Minn, MDNPI 1508119736
Title
MD
Phone
(855) 621-8250

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Peritoneal Dialysis Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WD1100X
Hemodialysis Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WH0500X
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary
Renal Dialysis TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 2472R0900X
Dialysis Equipment & Supplies (DME) 332BD1200X

Addresses

Primary practice location

917 Pacific Ave Ste 600
Tacoma, WA 98402-4437

Mailing address

917 Pacific Ave Ste 600
Tacoma, WA 98402-4437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231218002554 WA Part B Supplier - Clinic/Group Practice 1355790213 Receives reassigned benefits from 5 practitioners
Practice locations: Tacoma, WA

National Provider Directory

National Provider Directory

Locations

917 Pacific Ave
Ste 100
Tacoma, WA 98402
Phone (253) 670-3099

3020 S Union Ave
Tacoma, WA 98409
Phone (253) 844-4327

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783382400000",
    "number": "1285406249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 PACIFIC AVE STE 600",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 PACIFIC AVE STE 600",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024437",
            "telephone_number": "253-310-2236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC MEDICAL DIALYSIS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-24",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A",
        "authorized_official_last_name": "MINN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "855-621-8250",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163WD1100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Dialysis, Peritoneal",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WH0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Hemodialysis",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2472R0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Other, Renal Dialysis",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BD1200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.