| |
4104 South M Street Tacoma WA 98418-3836 | |
(253) 777-1434 | |
(253) 697-0015 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 4104 South M Street, Tacoma, Washington |
Authorized Official Name and Position | Ana Catalina Perera (CEO) |
Authorized Official Contact | 2537771434 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4104 S M St Tacoma WA 98418-3836 Ph: (253) 777-1434 | 4104 South M Street Tacoma WA 98418-3836 Ph: (253) 777-1434 |
NPI Number | 1891150504 |
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Provider Enumeration Date | 12/22/2015 |
Last Update Date | 05/08/2017 |
Identifier | Type | State | Issuer |
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1891150504 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 27 1011 00 (Washington) | Primary |
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