Provider Demographics
NPI:1073010583
Name:MULTICARE HEALTH SYSTEM
Entity Type:Organization
Organization Name:MULTICARE HEALTH SYSTEM
Other - Org Name:OLYMPIC SPORTS & SPINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER ENROLLMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:TUILEFANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-459-8231
Mailing Address - Street 1:315 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4234
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1450 5TH ST SE STE 4400
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-4691
Practice Address - Country:US
Practice Address - Phone:253-697-2340
Practice Address - Fax:253-697-2346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies