Healthcare Provider Details

I. General information

NPI: 1629105614
Provider Name (Legal Business Name): MARICEL L MORGENSEN NCLMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 S 312TH SUITE 202
FEDERAL WAY WA
98003-9028
US

IV. Provider business mailing address

6222 28TH ST NE
TACOMA WA
98422-3317
US

V. Phone/Fax

Practice location:
  • Phone: 253-946-2000
  • Fax:
Mailing address:
  • Phone: 253-946-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175L00000X
TaxonomyHomeopath
License NumberMA00019864
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: