Healthcare Provider Details

I. General information

NPI: 1497004519
Provider Name (Legal Business Name): TRANQUIL HEALING CENTER, PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2012
Last Update Date: 09/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23781 STATE HIGHWAY 3 STE 105
BELFAIR WA
98528
US

IV. Provider business mailing address

PO BOX 397
BELFAIR WA
98528-0397
US

V. Phone/Fax

Practice location:
  • Phone: 360-552-2525
  • Fax: 360-552-2527
Mailing address:
  • Phone: 360-552-2525
  • Fax: 360-552-2527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT0001625
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW60101787
License Number StateWA

VIII. Authorized Official

Name: DR. TERRA DIANE SOWINSKI
Title or Position: PRESIDENT, TREASURER, SECRETARY
Credential: ND. LM
Phone: 360-552-2525