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General NPI Number Information
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NPI Number | 1306915053
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Entity Type | Organization
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Legal Business Name | PACIFIC LUTHERAN UNIVERSITY
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12108 PACIFIC AVENUE PACIFIC LUTHERAN UNIVERSITY EAST CAMPUS, SUITE G-10
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City | TACOMA
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State | WA
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Zip | 98447-0003
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Country | US
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Telephone | 253-535-7354
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Fax | 253-535-7071
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Provider Business Mailing Address
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Address Line | 12108 PACIFIC AVENUE PACIFIC LUTHERAN UNIVERSITY EAST CAMPUS, SUITE G-10
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City | TACOMA
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State | WA
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Zip | 98447-0003
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Country | US
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Telephone | 253-535-7354
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Fax | 253-535-7071
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. RUTH M KOHLER
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Credential |
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Telephone | 253-535-8753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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