Healthcare Provider Details

I. General information

NPI: 1730043449
Provider Name (Legal Business Name): BIENESTAR NEUROPSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 A ST # 89
TACOMA WA
98402-5001
US

IV. Provider business mailing address

1102 A ST # 89
TACOMA WA
98402-5001
US

V. Phone/Fax

Practice location:
  • Phone: 253-527-6974
  • Fax: 253-352-2432
Mailing address:
  • Phone: 253-527-6974
  • Fax: 253-352-2432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JESSICA CRUZ
Title or Position: NEUROPSYCHOLOGIST
Credential: PHD
Phone: 206-375-8323