Healthcare Provider Details

I. General information

NPI: 1700793486
Provider Name (Legal Business Name): LUMA INTEGRATIVE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3228 170TH AVE E
LAKE TAPPS WA
98391-5530
US

IV. Provider business mailing address

3228 170TH AVE E
LAKE TAPPS WA
98391-5530
US

V. Phone/Fax

Practice location:
  • Phone: 425-541-1774
  • Fax: 425-940-2658
Mailing address:
  • Phone: 425-541-1774
  • Fax: 425-940-2658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRIANNE SMITH
Title or Position: OWNER/CLINICIAN
Credential:
Phone: 865-250-8092