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NPI Code Detail

MEDICARE: CHARITY MECHELINS MILES MSW

MEDICARE: CHARITY MECHELINS MILES MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorRC00052480WA
21041C0700XClinical Social WorkerLW60934869WA

General Provider Information

NPI Number : 1053593285
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARITY MECHELINS MILES MSW
Provider Business Mailing Address
First Line : 1105 113TH ST S
Second Line :
City : TACOMA
State : WA
Zip : 98444-4003
Country : US
Telephone Number : 253-232-3519
Fax Number :
Provider Business Practice Location Address
First Line : 9601 STEILACOOM BLVD SW
Second Line :
City : LAKEWOOD
State : WA
Zip : 98498-7212
Country : US
Telephone Number : 253-582-8900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2007
Last Update Date : 10/03/2024

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