NPIMap

Organization Active NPI

Cedar Medical Specialties

  • Ambulatory Surgical Clinic/Center
  • Tacoma, WA
National Provider Identifier
1376549618
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
FX00057086 Issued in WA
Legal business name
CEDAR MEDICAL SPECIALTIES
Practice address
2202 S Cedar St
Ste 100
Tacoma, WA 98405-2318
Phone
(253) 759-5555
Fax
(253) 830-5420
NPI assigned
Jun 22, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Robyn Wallace
Title
Practice Manager
Phone
(253) 759-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X FX00057086 WA Primary

Addresses

Primary practice location

2202 S Cedar St
Ste 100
Tacoma, WA 98405-2318

Mailing address

2202 S Cedar St
Ste 100
Tacoma, WA 98405-2318
Phone (253) 759-5555

Other identifiers 1

IdentifierTypeStateIssuer
7110224MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Allenmore Optical3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376549618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 S CEDAR ST",
            "address_2": "STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052318",
            "telephone_number": "253-759-5555",
            "fax_number": "253-830-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 S CEDAR ST",
            "address_2": "STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052318",
            "telephone_number": "253-759-5555",
            "fax_number": "253-830-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR MEDICAL SPECIALTIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "253-759-5555"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "FX00057086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7110224",
            "state": "WA"
        }
    ],
    "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 Aug 22, 2020; 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.