Healthcare Provider Details
I. General information
NPI: 1720126964
Provider Name (Legal Business Name): AUBURN VALLEY PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
202 N DIVISION ST PLAZA 2, SUITE 2
AUBURN WA
98001-4939
US
IV. Provider business mailing address
202 N DIVISION ST PLAZA 2, SUITE 2
AUBURN WA
98001-4939
US
V. Phone/Fax
- Phone: 253-876-0760
- Fax: 253-876-0771
- Phone: 253-876-0760
- Fax: 253-876-0771
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BRUCE
ORIEL
Title or Position: OWNER
Credential: M.D.
Phone: 253-876-0760