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General NPI Number Information
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NPI Number | 1962761155
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Entity Type | Organization
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Legal Business Name | 2 HANDS STUDIO, LCC
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Dates
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Enumeration Date | 05/09/2012
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Last Update Date | 05/09/2012
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Provider Practice Location Address
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Address Line | 1807 N STEVENS ST
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City | TACOMA
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State | WA
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Zip | 98406-3829
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Country | US
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Telephone | 253-590-6878
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Fax |
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Provider Business Mailing Address
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Address Line | 1807 N STEVENS STREET
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City | TACOMA
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State | WA
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Zip | 98406
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Country | US
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Telephone | 253-590-6878
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE KOSCELNIK
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Credential | LMP
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Telephone | 253-590-6878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | MA000021913
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License Number State | WA
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