Provider Demographics
NPI:1750597480
Name:DEDICATED WOMENS HEALTH SPECIALISTS INC P.S.
Entity type:Organization
Organization Name:DEDICATED WOMENS HEALTH SPECIALISTS INC P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:H
Authorized Official - Last Name:EUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-840-4444
Mailing Address - Street 1:1701 3RD ST SE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-4511
Mailing Address - Country:US
Mailing Address - Phone:253-840-4444
Mailing Address - Fax:253-840-5239
Practice Address - Street 1:1701 3RD ST SE
Practice Address - Street 2:SUITE 200
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-4511
Practice Address - Country:US
Practice Address - Phone:253-840-4444
Practice Address - Fax:253-840-5239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00031953207V00000X
WAMD00045275207V00000X
WAMD00026074207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7085020Medicaid
C74735Medicare UPIN
WAGAB25749Medicare ID - Type Unspecified
WAI44317Medicare UPIN
WA7085020Medicaid