NPI 1124371497

Rejuvenate Wellness Day Spa, Ps

Organisation Health Maintenance Organization Lakewood, WA

Practice location

Address: 7521 Bridgeport Way W STE B, Lakewood, WA 98499-2423
Phone: (253) 503-7055
Mailing address: PO Box 88021, Steilacoom, WA 98388-0021

Authorised official

Name: Sung Ye Pak
Title: Vice President
Phone: (253) 503-7055

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence MA00023361 (WA)

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Registry record

NPI: 1124371497
Entity type: Organization
NPI issued: 23 Oct 2012
Record last updated: 23 Oct 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.