Provider Demographics
NPI:1730106568
Name:PACIFIC NEPHROLOGY ASSOCIATES, P.S.
Entity Type:Organization
Organization Name:PACIFIC NEPHROLOGY ASSOCIATES, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZHENG
Authorized Official - Middle Name:
Authorized Official - Last Name:GE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-627-5755
Mailing Address - Street 1:1901 S UNION AVE
Mailing Address - Street 2:B7011
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1702
Mailing Address - Country:US
Mailing Address - Phone:206-592-5000
Mailing Address - Fax:206-824-9510
Practice Address - Street 1:1901 S UNION AVE
Practice Address - Street 2:SUITE B7011
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1702
Practice Address - Country:US
Practice Address - Phone:253-627-5755
Practice Address - Fax:253-627-7385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7077472Medicaid
WA7077472Medicaid
WA=========OtherPREMERA BLUE CROSS
WA=========OtherAETNA
WA=========OtherPACIFICARE
WA=========OtherUNITED HEALTHCARE