| |
1201 Pacific Ave Ste 600 Tacoma WA 98402 | |
(253) 235-9158 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 1201 Pacific Ave Ste 600, Tacoma, Washington |
Authorized Official Name and Position | Cheryl Chua Dann (OWNER) |
Authorized Official Contact | 2532359158 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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100 N Howard St Ste R Spokane WA 99201-0508 Ph: (253) 235-9158 | 1201 Pacific Ave Ste 600 Tacoma WA 98402 Ph: (253) 235-9158 |
NPI Number | 1649957796 |
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Provider Enumeration Date | 06/30/2023 |
Last Update Date | 02/16/2024 |
Certification Date | 02/16/2024 |
Medicare PECOS PAC ID | 4486018991 |
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Medicare Enrollment ID | O20230918001999 |
Identifier | Type | State | Issuer |
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1649957796 | NPI | - | NPPES |
Provider Name | Cheryl Chua Dann |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225673817 PECOS PAC ID: 4981002839 Enrollment ID: I20211007002188 |
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