NPIMap

Organization Active NPI

Rainier Anesthesia Associates PC

  • Anesthesiology Physician
  • Puyallup, WA
National Provider Identifier
1487637013
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
RAINIER ANESTHESIA ASSOCIATES PC
Practice address
400 E Pioneer Ste 101
Puyallup, WA 98372-3256
Phone
(253) 445-5828
NPI assigned
Nov 29, 2005
Last updated
Mar 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Authorized official

Name
Brian Wallace, MDNPI 1790017028
Title
Head of Group
Phone
(713) 447-2353

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
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

400 E Pioneer Ste 101
Puyallup, WA 98372-3256

Mailing address

PO Box 1737
Tacoma, WA 98401-1737
Phone (253) 445-5828

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315000756 WA Part B Supplier - Clinic/Group Practice 4284523499 Receives reassigned benefits from 120 practitioners
Practice locations: Puyallup, WA; Lakewood, WA; Covington, WA; Auburn, WA

National Provider Directory

National Provider Directory

Locations

3801 5th St SE
Puyallup, WA 98374
Phone (253) 435-4774

400 E Pioneer
Ste 101
Puyallup, WA 98372
Phone (253) 445-5828

400 E Pioneer
Ste 204
Puyallup, WA 98372
Phone (253) 445-5828

Practitioners & affiliated clinicians

Practitioners 120

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.

View all 120

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616112000000",
    "number": "1487637013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1737",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984011737",
            "telephone_number": "253-445-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E PIONEER STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723256",
            "telephone_number": "253-445-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINIER ANESTHESIA ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-29",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "HEAD OF GROUP",
        "authorized_official_telephone_number": "713-447-2353",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 19, 2021; 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.