Organization
MIKKADESH MENTAL HEALTHCARE LLC
Active
Other names
Mikkadesh Mental Healthcare LLC
Organization subpart
No
Provider details
NPI number
Authorized official
VERONICA ABEH FORCHU (PRESIDENT/ADMINISTRATOR)
(801) 649-7584
Entity
Organization
Contact information
Practice address
12923 EMERALD RIDGE BLVD E, PUYALLUP, WA 98374-8403
(801) 649-7584
Mailing address
12923 EMERALD RIDGE BLVD E, PUYALLUP, WA 98374-8403
(801) 649-7584
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/09/2022
Last updated
12/10/2024
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