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General NPI Number Information
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NPI Number | 1134932379
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Entity Type | Organization
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Legal Business Name | RHEMA AESTHETICS AND WELLNESS LLC
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Dates
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Enumeration Date | 01/30/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 4509 TALBOT RD S STE 105
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City | RENTON
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State | WA
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Zip | 98055-6294
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Country | US
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Telephone | 360-350-9230
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Fax |
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Provider Business Mailing Address
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Address Line | 4509 TALBOT RD S STE 105
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City | RENTON
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State | WA
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Zip | 98055-6294
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Country | US
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Telephone | 360-350-9230
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Fax | 425-276-9905
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Authorized Official
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Title or Position | ARNP/CEO
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Name | PHUONG LE
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Credential |
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Telephone | 360-350-9230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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