Organization Active NPI

Trinity Family Medical Clinic

  • Family Medicine Physician
  • Puyallup, WA
National Provider Identifier
1639617038
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00042936 Issued in WA
Legal business name
TRINITY FAMILY MEDICAL CLINIC
Practice address
610 S Meridian
Puyallup, WA 98371
Phone
(253) 881-1844
Fax
(253) 881-1925
NPI assigned
Feb 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Authorized official

Name
Eugenia D Guray, MDNPI 1275506263
Title
Owner
Phone
(253) 881-1844

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD00042936 WA Primary

Addresses

Primary practice location

610 S Meridian
Puyallup, WA 98371

Mailing address

610 S Meridian
Puyallup, WA 98371-5908
Phone (855) 621-8250

Other names 1

  • Trinity Family Medical Clinic PS, INC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170621001212 WA Part B Supplier - Clinic/Group Practice 5991073645 Receives reassigned benefits from 4 practitioners
Practice locations: Puyallup, WA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2129441Trinity Family Medical Clinic PS Inc610 S Meridian, Puyallup, WA 98371Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

610 S Meridian
Puyallup, WA 98371
Phone (253) 845-2629

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": "1486339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1639617038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S MERIDIAN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983715908",
            "telephone_number": "855-621-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S MERIDIAN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98371",
            "telephone_number": "253-881-1844",
            "fax_number": "253-881-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY FAMILY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-06",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "GURAY",
        "authorized_official_first_name": "EUGENIA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-881-1844",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00042936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Family Medical Clinic PS, INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.