Healthcare Provider Details

I. General information

NPI: 1609601871
Provider Name (Legal Business Name): OHANA CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2406 178TH ST E
TACOMA WA
98445-4217
US

IV. Provider business mailing address

2406 178TH ST E
TACOMA WA
98445-4217
US

V. Phone/Fax

Practice location:
  • Phone: 510-402-9460
  • Fax: 253-242-5068
Mailing address:
  • Phone: 510-402-9460
  • Fax: 253-242-5068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: RAENIELLE SUNGA
Title or Position: CO-OWNER
Credential:
Phone: 510-402-9460