Individual
SERENA GRUBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 477-3456
(253) 967-2639
Mailing address
BLDG 11582 17TH & C STREET, JBLM, WA 98433
(253) 477-3456
(253) 967-2639
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN175943
GA
163WC0400X
Case Management Registered Nurse
Primary
RN175943
GA
Other
Enumeration date
04/08/2016
Last updated
05/19/2022
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