Provider Demographics
NPI:1720126964
Name:AUBURN VALLEY PEDIATRICS
Entity Type:Organization
Organization Name:AUBURN VALLEY PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:ORIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-876-0760
Mailing Address - Street 1:202 N DIVISION ST
Mailing Address - Street 2:PLAZA 2, SUITE 2
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-4939
Mailing Address - Country:US
Mailing Address - Phone:253-876-0760
Mailing Address - Fax:253-876-0771
Practice Address - Street 1:202 N DIVISION ST
Practice Address - Street 2:PLAZA 2, SUITE 2
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-4939
Practice Address - Country:US
Practice Address - Phone:253-876-0760
Practice Address - Fax:253-876-0771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Not Answered363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty