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General NPI Number Information
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NPI Number | 1578927794
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Entity Type | Organization
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Legal Business Name | MADIGAN ARMY MEDICAL CENTER
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Dates
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Enumeration Date | 04/13/2016
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Last Update Date | 04/13/2016
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Provider Practice Location Address
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Address Line | 9040 A JACKSON AVE
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City | TACOMA
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State | WA
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Zip | 98431-1100
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Country | US
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Telephone | 253-966-7522
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Fax |
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Provider Business Mailing Address
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Address Line | 8804 SILCOX DR SW
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City | LAKEWOOD
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State | WA
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Zip | 98498-2102
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Country | US
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Telephone | 253-732-3813
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | MRS. LAURA CAMILLE SMITH-FINONA
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Credential | LPN
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Telephone | 253-732-3813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | LP00034939
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License Number State | WA
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