Healthcare Provider Details

I. General information

NPI: 1205484383
Provider Name (Legal Business Name): RISE WITH CHANGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2019
Last Update Date: 08/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3711 PACIFIC AVE STE 200
TACOMA WA
98418-7800
US

IV. Provider business mailing address

3711 PACIFIC AVE STE 200
TACOMA WA
98418-7800
US

V. Phone/Fax

Practice location:
  • Phone: 253-471-3464
  • Fax:
Mailing address:
  • Phone: 253-471-3464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: JULIET MARSH
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 406-471-0727