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General NPI Number Information
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NPI Number | 1265152169
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Entity Type | Organization
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Legal Business Name | TUBMAN CENTER FOR HEALTH & FREEDOM
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Dates
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Enumeration Date | 08/31/2022
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 6020 RAINIER AVE S
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City | SEATTLE
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State | WA
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Zip | 98118-2776
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Country | US
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Telephone | 206-702-8101
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 18612
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City | SEATTLE
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State | WA
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Zip | 98118-0612
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NATUROPATHIC PHYSICIAN
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Name | LAUREN BLACKHAM
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Credential | NP
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Telephone | 206-702-8101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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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 | 2080S0010X
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Taxonomy Name | Pediatric Sports Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 364SS0200X
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Taxonomy Name | School Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 364SX0106X
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Taxonomy Name | Occupational Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LS0200X
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Taxonomy Name | School Nurse Practitioner
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License Number |
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License Number State |
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