Up Family Medicine PLLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

UP FAMILY MEDICINE PLLC

Practice address

4114 Bridgeport Way W
University Place, WA 98466-4315

Phone

(253) 564-8100

Fax

(253) 564-8387

NPI assigned

Apr 24, 2020

Organization subpart

No

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

Authorized official

Name

Tai Davalos

Title

Manager

Phone

(253) 564-8100

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

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

• Edward D Corley, DC

  • Rehabilitation Chiropractor
  • University Place, WA
  • NPI 1821151820
  NPD (past)

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

{
    "created_epoch": "1587686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587686400000",
    "number": "1417577909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 BRIDGEPORT WAY W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664315",
            "telephone_number": "253-564-8100",
            "fax_number": "253-564-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4114 BRIDGEPORT WAY W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664315",
            "telephone_number": "253-564-8100",
            "fax_number": "253-564-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UP FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-24",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A",
        "authorized_official_last_name": "DAVALOS",
        "authorized_official_first_name": "TAI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "253-564-8100"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tai@pacificwellness.net",
            "affiliation": "N",
            "address_1": "4114 Bridgeport Way W",
            "city": "University Place",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984664315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• University Place Dental Clinic
• University Place Massage, LLC
• University Place Rehabilitation Center, LLC
• University Place School
• University Place Smiles PLLC
• Simran Uppal
• Victor Urbina
• Cassandra Garcia Uribe, LICSW
• Kim Valentine, LMP
• Todd D Valentine, LMP, SMT, NSCA-CPT

• Health Service Clinic/Center in University Place, WA
• Providers in University Place, WA by specialty
• Health Service Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.