=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750743274
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EVERYBODY'S HEALTH CLINIC, PS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/23/2016
-----------------------------------------------------
Last Update Date | 03/23/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 710 S 38TH ST
-----------------------------------------------------
City | TACOMA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98418-6718
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-301-0782
-----------------------------------------------------
Fax | 855-635-5250
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 710 S 38TH ST
-----------------------------------------------------
City | TACOMA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98418-6718
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-301-0782
-----------------------------------------------------
Fax | 855-635-5250
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | DR. ROSALIE N NGUYEN
-----------------------------------------------------
Credential | PHARMD.
-----------------------------------------------------
Telephone | 616-990-5909
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------