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3580 Pacific Ave Tacoma WA 98418-7915 | |
| (253) 798-4500 | |
| (253) 798-4493 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3580 Pacific Ave, Tacoma, Washington |
| Authorized Official Name and Position | David E. Stewart (DIRECTOR) |
| Authorized Official Contact | 2537984500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3580 Pacific Ave Tacoma WA 98418-7915 Ph: (253) 798-4500 | 3580 Pacific Ave Tacoma WA 98418-7915 Ph: (253) 798-4500 |
| NPI Number | 1043459720 |
|---|---|
| Provider Enumeration Date | 02/19/2009 |
| Last Update Date | 02/19/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043459720 | NPI | - | NPPES |
| 6030548 | Medicaid | WA | |
| 7142797 | Medicaid | WA | |
| 7136344 | Medicaid | WA | |
| 7139710 | Medicaid | WA | |
| 9657370 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | RFT-1077 (Washington) | Primary |
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