Healthcare Provider Details

I. General information

NPI: 1730008756
Provider Name (Legal Business Name): COMPREHENSIVE LIFE RESOURECES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 FAWCETT AVE
TACOMA WA
98402-5503
US

IV. Provider business mailing address

737 FAWCETT AVE
TACOMA WA
98402-5503
US

V. Phone/Fax

Practice location:
  • Phone: 253-339-1647
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: SHANTIA LEE
Title or Position: PEER/WISE
Credential:
Phone: 253-339-1647