| |
748 Market St Ste 80 Tacoma WA 98402-3737 | |
(253) 348-2242 | |
(253) 697-9938 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 748 Market St Ste 80, Tacoma, Washington |
Authorized Official Name and Position | Eric Thomas Cuestas-thompson (THERAPIST) |
Authorized Official Contact | 2533482242 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1019 29th Street Pl Nw Puyallup WA 98371-3519 Ph: (253) 348-2242 | 748 Market St Ste 80 Tacoma WA 98402-3737 Ph: (253) 348-2242 |
NPI Number | 1134491293 |
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Provider Enumeration Date | 02/06/2012 |
Last Update Date | 09/30/2022 |
Certification Date | 09/30/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134491293 | NPI | - | NPPES |
2044698 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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