Organization
REJUVENATE WELLNESS DAY SPA, PS
Active
Other names
Wellness Day Spa
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUNG YE PAK MA00023361 (VICE PRESIDENT)
(253) 503-7055
Entity
Organization
Contact information
Practice address
7521 BRIDGEPORT WAY W STE B, LAKEWOOD, WA 98499-2423
(253) 503-7055
Mailing address
PO BOX 88021, STEILACOOM, WA 98388-0021
(253) 503-7055
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
MA00023361
WA
Other
Enumeration date
10/23/2012
Last updated
10/23/2012
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