OrganizationActive
Up Family Medicine PLLC
NPI 1417577909 · Health Service Clinic/Center · University Place, WA
Provider details
- NPI number
- 1417577909
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Tai Davalos, Manager(253) 564-8100
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4114 Bridgeport Way W
University Place, WA 98466-4315
Phone: (253) 564-8100
Fax: (253) 564-8387
Street-level locationGet directions
Mailing address
4114 Bridgeport Way W
University Place, WA 98466-4315
Registry dates
- Enumerated
- 2020-04-24
- Last updated
- 2020-04-24
- Certified
- 2020-04-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.