| |
9102 Bridgeport Way Sw Lakewood WA 98499-2418 | |
(253) 302-3826 | |
(253) 267-5212 |
Full Name | |
---|---|
Speciality | Community/behavioral Health |
Location | 9102 Bridgeport Way Sw, Lakewood, Washington |
Authorized Official Name and Position | Tae Son Lee (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2533023826 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
9100 Bridgeport Way Sw Lakewood WA 98499-2427 Ph: (253) 302-3826 | 9102 Bridgeport Way Sw Lakewood WA 98499-2418 Ph: (253) 302-3826 |
NPI Number | 1144451048 |
---|---|
Provider Enumeration Date | 07/27/2009 |
Last Update Date | 12/09/2024 |
Certification Date | 12/09/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144451048 | NPI | - | NPPES |
2001629 | Medicaid | WA |
Paul Kenneth Henry Med Lmhc Ps Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9101 Bridgeport Way Sw Ste D2, Lakewood, WA 98499 Phone: 253-394-6045 | |
Lakewood Wellness Clinic Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10310 Gravelly Lake Dr Sw Ste B, Lakewood, WA 98499 Phone: 253-888-3405 |