Provider Demographics
NPI:1154392405
Name:KLEIVER, TRINA M (MD)
Entity type:Individual
Prefix:DR
First Name:TRINA
Middle Name:M
Last Name:KLEIVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E PIONEER STE 204
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-3257
Mailing Address - Country:US
Mailing Address - Phone:253-445-5828
Mailing Address - Fax:
Practice Address - Street 1:400 E PIONEER STE 204
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3257
Practice Address - Country:US
Practice Address - Phone:253-445-5828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60205197207L00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology