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General NPI Number Information
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NPI Number | 1184560971
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Entity Type | Organization
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Legal Business Name | MIND AND BODY PSYCHIATRY
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Dates
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Enumeration Date | 04/25/2026
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Last Update Date | 04/25/2026
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Provider Practice Location Address
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Address Line | 748 MARKET ST # 67
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City | TACOMA
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State | WA
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Zip | 98402-3737
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Country | US
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Telephone | 206-929-4410
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Fax |
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Provider Business Mailing Address
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Address Line | 748 MARKET ST # 67
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City | TACOMA
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State | WA
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Zip | 98402-3737
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Country | US
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Telephone | 206-929-4410
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA AMIGO
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Credential | PMHNP-BC
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Telephone | 786-932-8830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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