# PRESTIGE MENTAL HEALTH

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

## Provider details

- **NPI number:** 1881452571
- **Authorized official:** MILLICENT MBUA NP (PRESIDENT)
- **Authorized official phone:** (253) 293-0683

## Contact information

- **Practice address:** 7720 190TH AVE E, BONNEY LAKE, WA 98391-7010
- **Practice address phone:** (253) 293-0683
- **Practice address fax:** (253) 397-4640
- **Mailing address:** 7720 190TH AVE E, BONNEY LAKE, WA 98391-7010
- **Mailing address phone:** (253) 293-0683
- **Mailing address fax:** (253) 397-4640

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/08/2024
- **Last updated:** 03/08/2024