Healthcare Provider Details

I. General information

NPI: 1083806475
Provider Name (Legal Business Name): DENISE RACHEL BESSETTE LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2007
Last Update Date: 08/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7610 40TH ST W
UNIVERSITY PLACE WA
98466-3834
US

IV. Provider business mailing address

1000 TOWN CTR NE STE 180 BOX 110
TACOMA WA
98422-1194
US

V. Phone/Fax

Practice location:
  • Phone: 253-507-7231
  • Fax:
Mailing address:
  • Phone: 253-335-9391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA00008221
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: