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General NPI Number Information
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NPI Number | 1588432918
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Entity Type | Organization
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Legal Business Name | ENRICH COMMUNITY PSYCHIATRY PLLC
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Dates
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Enumeration Date | 12/14/2023
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 14821 18TH AVE E
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City | TACOMA
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State | WA
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Zip | 98445-3477
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Country | US
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Telephone | 678-777-9744
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Fax |
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Provider Business Mailing Address
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Address Line | 14821 18TH AVE E
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City | TACOMA
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State | WA
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Zip | 98445-3477
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Country | US
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Telephone | 678-777-9744
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Fax |
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Authorized Official
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Title or Position | OWNER OF THE ENTITY
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Name | LUCY WAITHAKA
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Credential |
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Telephone | 678-777-9744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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