# UNITED STATES PUBLIC HEALTH SERVICE

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

## Provider details

- **NPI number:** 1972871838
- **Authorized official:** JONHNNY BROUSSARD (HEALTH SERVICE ADMINITRATOR)
- **Authorized official phone:** (253) 779-6052

## Contact information

- **Practice address:** 1623 E J ST, TACOMA, WA 98421-1602
- **Practice address phone:** (253) 552-4947
- **Practice address fax:** (253) 779-6005
- **Mailing address:** 1623 E J ST, TACOMA, WA 98421-1602
- **Mailing address phone:** (253) 552-4947
- **Mailing address fax:** (253) 779-6005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | AP30005661 | WA | Yes |

## Other

- **Enumeration date:** 12/07/2011
- **Last updated:** 12/07/2011