Healthcare Provider Details

I. General information

NPI: 1598356354
Provider Name (Legal Business Name): BIMA SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2021
Last Update Date: 02/03/2021
Certification Date: 02/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 MARTIN LUTHER KING JR WAY
TACOMA WA
98405-4152
US

IV. Provider business mailing address

PO BOX 98183
LAKEWOOD WA
98496-8183
US

V. Phone/Fax

Practice location:
  • Phone: 206-393-2273
  • Fax: 253-302-3492
Mailing address:
  • Phone: 206-393-2273
  • Fax: 253-302-3492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRIDGETTE JOHNSON
Title or Position: CEO
Credential: SOCIAL WORKER
Phone: 206-393-2273