Provider Demographics
NPI:1700641438
Name:KIDS 0 TO 18 INTEGRATIVE PEDIATRICS -AKA CONCIERGE PEDIATRICS
Entity type:Organization
Organization Name:KIDS 0 TO 18 INTEGRATIVE PEDIATRICS -AKA CONCIERGE PEDIATRICS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER - NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:NNP-BC, CPNP-PC&AC
Authorized Official - Phone:253-400-0218
Mailing Address - Street 1:4700 POINT FOSDICK DR STE 208
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1775
Mailing Address - Country:US
Mailing Address - Phone:253-400-0218
Mailing Address - Fax:253-500-0218
Practice Address - Street 1:4700 POINT FOSDICK DR STE 208
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1775
Practice Address - Country:US
Practice Address - Phone:253-400-0218
Practice Address - Fax:253-500-0218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2025-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty