# US ARMY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710429279
- **Authorized official:** DR. KIMBERLY ANN GENKOV DNP, PMHNP-BC (PSYCHIATRIC NURSE PRACTITIONER)
- **Authorized official phone:** (248) 909-7531

## Contact information

- **Practice address:** MADIGAN ARMY MEDICAL CTR, 9040 JACKSON AVE, TACOMA, WA 98431-0001
- **Practice address phone:** (253) 968-1110
- **Mailing address:** 800 ROE ST, STEILACOOM, WA 98388-4006
- **Mailing address phone:** (248) 909-7531

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/14/2016
- **Last updated:** 11/14/2016