Organization Active NPI

Dedicated Womens Health Specialists Inc P.S.

  • Obstetrics & Gynecology Physician
  • Puyallup, WA
National Provider Identifier
1750597480
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD00026074 Issued in WA
Legal business name
DEDICATED WOMENS HEALTH SPECIALISTS INC P.S.
Practice address
1701 3Rd St SE
Suite 200
Puyallup, WA 98372-4511
Phone
(253) 840-4444
Fax
(253) 840-5239
NPI assigned
May 16, 2007
Last updated
Jun 15, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Authorized official

Name
Paul H Eun, MDNPI 1841393865
Title
Owner
Phone
(253) 840-4444

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD00031953 WA
Obstetrics & Gynecology Physician 207V00000X MD00045275 WA
Obstetrics & Gynecology Physician 207V00000X MD00026074 WA Primary

Addresses

Primary practice location

1701 3Rd St SE
Suite 200
Puyallup, WA 98372-4511

Mailing address

1701 3Rd St SE
Suite 200
Puyallup, WA 98372-4511
Phone (253) 840-4444

Other identifiers 1

IdentifierTypeStateIssuer
7085020MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040224000965 WA Part B Supplier - Clinic/Group Practice 4082500392 Receives reassigned benefits from 4 practitioners
Practice locations: Puyallup, WA

National Provider Directory

National Provider Directory

Locations

1701 3rd St SE
Ste 200
Puyallup, WA 98372
Phone (253) 840-4444

3912 10th St SE
#100
Puyallup, WA 98374
Phone (253) 840-4444

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339718400000",
    "number": "1750597480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 3RD ST SE",
            "address_2": "SUITE 200",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983724511",
            "telephone_number": "253-840-4444",
            "fax_number": "253-840-5239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 3RD ST SE",
            "address_2": "SUITE 200",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983724511",
            "telephone_number": "253-840-4444",
            "fax_number": "253-840-5239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEDICATED WOMENS HEALTH SPECIALISTS INC P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2012-06-15",
        "status": "A",
        "authorized_official_last_name": "EUN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-840-4444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD00031953",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD00045275",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD00026074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7085020",
            "state": "WA"
        }
    ],
    "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 Jun 15, 2012; 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.