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Organization
RENEGADE HEALING CO., LLC
Active
Organization
RENEGADE HEALING CO., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY KUBAT LMHC, SUDP (OWNER/CLINICIAN)
(253) 617-8857
Entity
Organization
Contact information
Practice address
5711 N VISTA GRANDE DR, OTIS ORCHARDS, WA 99027-9103
(253) 617-8857
Mailing address
5711 N VISTA GRANDE DR, OTIS ORCHARDS, WA 99027-9103
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/01/2026
Last updated
01/01/2026
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