Healthcare Provider Details

I. General information

NPI: 1871906339
Provider Name (Legal Business Name): TROY P UNDERBRINK D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2014
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2209 N PEARL ST
TACOMA WA
98406-2529
US

IV. Provider business mailing address

2209 N PEARL ST
TACOMA WA
98406-2529
US

V. Phone/Fax

Practice location:
  • Phone: 253-792-6900
  • Fax: 253-459-7106
Mailing address:
  • Phone: 253-792-6900
  • Fax: 253-459-7106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOP60583729
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: