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General NPI Number Information
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NPI Number | 1740281344
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Entity Type | Organization
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Legal Business Name | PUYALLUP DERMATOLOGY CLINIC INC P.S.
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Dates
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Enumeration Date | 08/03/2005
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 2622 S MERIDIAN
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City | PUYALLUP
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State | WA
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Zip | 98373-1500
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Country | US
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Telephone | 253-841-2453
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Fax | 253-840-5519
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Provider Business Mailing Address
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Address Line | 929 E MAIN AVE SUITE 210
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City | PUYALLUP
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State | WA
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Zip | 98372-3116
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Country | US
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Telephone | 253-841-2453
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Fax | 253-840-5519
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Authorized Official
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Title or Position | OWNER
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Name | DR. JASON MEEKER
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Credential | M.D.
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Telephone | 253-841-2453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD00038522
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License Number State | WA
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