| |
504 112th Street S. Tacoma WA 98444 | |
(253) 536-5549 | |
(253) 536-1255 |
Full Name | |
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Speciality | Counselor |
Location | 504 112th Street S., Tacoma, Washington |
Authorized Official Name and Position | Robin Michelle Meng (CEO/OWNER) |
Authorized Official Contact | 2535365549 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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504 112th Street S. Tacoma WA 98444 Ph: (253) 536-5549 | 504 112th Street S. Tacoma WA 98444 Ph: (253) 536-5549 |
NPI Number | 1093986564 |
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Provider Enumeration Date | 03/12/2008 |
Last Update Date | 08/27/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093986564 | NPI | - | NPPES |
CAQH12657245 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | CP60061821 (Washington) | Primary |
251B00000X | Case Management | CP00001279 (Washington) | Secondary |
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