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General NPI Number Information
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NPI Number | 1770557290
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF PUGET SOUND
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1500 N WARNER ST CMB 1035
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City | TACOMA
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State | WA
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Zip | 98416-5000
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Country | US
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Telephone | 253-879-1555
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Fax | 253-879-3766
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Provider Business Mailing Address
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Address Line | 1500 N WARNER ST CMB 1035
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City | TACOMA
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State | WA
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Zip | 98416-5000
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Country | US
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Telephone | 253-879-1555
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Fax | 253-879-3766
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Authorized Official
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Title or Position | ASSIST DIRECTOR/MEDICAL COORDINATOR
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Name | MRS. LINDA M EVERSON
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Credential | RN-C
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Telephone | 253-879-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number | RN00036600
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License Number State | WA
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