Healthcare Provider Details

I. General information

NPI: 1053918698
Provider Name (Legal Business Name): DISCOVERY PRACTICE MANAGEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2020
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40903 236TH AVE SE
ENUMCLAW WA
98022-8606
US

IV. Provider business mailing address

4281 KATELLA AVE STE 111
LOS ALAMITOS CA
90720-3588
US

V. Phone/Fax

Practice location:
  • Phone: 360-218-2832
  • Fax:
Mailing address:
  • Phone: 562-588-4722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: NATALIE BRYANT
Title or Position: DIRECTOR OF BUSINESS DEVELOPMENT
Credential:
Phone: 562-588-4722