Healthcare Provider Details

I. General information

NPI: 1255216503
Provider Name (Legal Business Name): NEBICARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2302 S UNION AVE STE C30
TACOMA WA
98405-1334
US

IV. Provider business mailing address

2302 S UNION AVE STE C30
TACOMA WA
98405-1334
US

V. Phone/Fax

Practice location:
  • Phone: 425-738-7942
  • Fax: 425-572-6509
Mailing address:
  • Phone: 425-738-7942
  • Fax: 425-572-6509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. HELINA JIMMA
Title or Position: ARNP
Credential: ARNP
Phone: 425-516-1042