OrganizationActive
Concordia Star Medical LLC
NPI 1508134792 · Primary Care Clinic/Center · Puyallup, WA
Provider details
- NPI number
- 1508134792
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Ladie Arana-Domondon, Owner - Ceo(253) 209-9009
- License
- MD00034362 (WA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 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
118 7th Ave Sw
Suite a
Puyallup, WA 98371-6803
Phone: (253) 579-0067
Fax: (253) 579-0068
Street-level locationGet directions
Mailing address
118 7th Ave Sw
Puyallup, WA 98371-6803
Registry dates
- Enumerated
- 2011-12-02
- Last updated
- 2015-05-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.