Healthcare Provider Details

I. General information

NPI: 1609584663
Provider Name (Legal Business Name): LILIANA ARIELA -ELYARA ESTRADA GONZALEZ ND,DHH, DNM,BCIP,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2022
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2367 TACOMA AVE S STE 110
TACOMA WA
98402-1409
US

IV. Provider business mailing address

PO BOX 4521
FEDERAL WAY WA
98063-4521
US

V. Phone/Fax

Practice location:
  • Phone: 253-401-5535
  • Fax:
Mailing address:
  • Phone: 253-401-5535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172P00000X
TaxonomyNaprapath
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374K00000X
TaxonomyReligious Nonmedical Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: