Eterna Vein & Medical Aesthetics, PLLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

603211178 Issued in WA

Legal business name

ETERNA VEIN & MEDICAL AESTHETICS, PLLC

Practice address

1803 S Meridian
Puyallup, WA 98371-7513

Phone

(253) 268-3400

NPI assigned

Apr 4, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Robert W Osborne Jr., MD

Title

Owner

Phone

(253) 268-3400

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 3

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

• Megan Barker

  • Family Nurse Practitioner
  • Bonney Lake, WA
  • NPI 1083080956
  Medicare reassignment NPD
• Mark S. Kim, MD

  • Phlebology Physician
  • Puyallup, WA
  • NPI 1053403634
  Medicare reassignment
• Jessica Armitage, ARNP

  • Nurse Practitioner
  • Sumner, WA
  • NPI 1922510726
  NPD (past)

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371081600000",
    "number": "1366785685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 S MERIDIAN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717513",
            "telephone_number": "253-268-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 S MERIDIAN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717513",
            "telephone_number": "253-268-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETERNA VEIN & MEDICAL AESTHETICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-04",
        "last_updated": "2013-06-13",
        "status": "A",
        "authorized_official_last_name": "OSBORNE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-268-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "WA",
            "license": "603211178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabreehna Essien
• Establishing Order Christian Ministries
• Pieter V Esterhay, M.D.
• Kayla Estes
• Joel Fausto Kliatchko Estrada, MD
• Roger Nicholas Etherington, LMHC
• Anthonie Ontreay Etienne, LMFT
• Anne Eugenio, LMFTA
• Erika A Euker, PA-C
• Paul H Eun, MD

• Vascular Surgery Physician in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Vascular Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.