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6604 Wildaire Rd Sw Lakewood WA 98499-1333 | |
(253) 444-4908 | |
Not Available |
Full Name | |
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Speciality | Community/Behavioral Health |
Location | 6604 Wildaire Rd Sw, Lakewood, Washington |
Authorized Official Name and Position | Steven Monks (OWNER) |
Authorized Official Contact | 2534444908 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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6604 Wildaire Rd Sw Lakewood WA 98499-1333 Ph: (253) 444-4908 | 6604 Wildaire Rd Sw Lakewood WA 98499-1333 Ph: (253) 444-4908 |
NPI Number | 1215616776 |
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Provider Enumeration Date | 07/12/2023 |
Last Update Date | 01/14/2025 |
Certification Date | 01/14/2025 |
Medicare PECOS PAC ID | 1254794076 |
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Medicare Enrollment ID | O20230828001222 |
Identifier | Type | State | Issuer |
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1215616776 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Steven Michael Monks |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1285230300 PECOS PAC ID: 4183087737 Enrollment ID: I20230831004256 |
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