| Loving Heart Pllc | |
|
4610 6th Street Pl Se Puyallup WA 98374-5791 | |
| (878) 228-0000 | |
| Not Available |
| Full Name | Loving Heart Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 4610 6th Street Pl Se, Puyallup, Washington |
| Authorized Official Name and Position | Junior Germeille (OWNER) |
| Authorized Official Contact | 2398887400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Loving Heart Pllc 4610 6th Street Pl Se Puyallup WA 98374-5791 Ph: () - | Loving Heart Pllc 4610 6th Street Pl Se Puyallup WA 98374-5791 Ph: (878) 228-0000 |
| NPI Number | 1720850563 |
|---|---|
| Provider Enumeration Date | 10/25/2023 |
| Last Update Date | 12/07/2023 |
| Medicare PECOS PAC ID | 3678923208 |
|---|---|
| Medicare Enrollment ID | O20231222001523 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720850563 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Junior Germeille |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477295566 PECOS PAC ID: 4880078385 Enrollment ID: I20220901001737 |
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