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Organization
LAKEWOOD WELLNESS CLINIC
Active
Organization
LAKEWOOD WELLNESS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER RUBIO ARNP (OWNER)
(253) 208-3179
Entity
Organization
Contact information
Practice address
10310 GRAVELLY LAKE DR SW STE B, LAKEWOOD, WA 98499-5014
(253) 888-3405
Mailing address
10310 GRAVELLY LAKE DR SW STE B, LAKEWOOD, WA 98499-5014
(253) 888-3405
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/08/2019
Last updated
11/21/2019
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