Organization
REVAMP SERVICES INC
Active
Organization
REVAMP SERVICES INC
Active
Other names
RevampDr LLC, RevampDR
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRACE MWANGI DNP-FNP-C (CEO)
(206) 327-8403
Entity
Organization
Contact information
Practice address
1702 S 72ND ST STE D, TACOMA, WA 98408-1238
(206) 327-8403
Mailing address
7705 S JUNETT ST, TACOMA, WA 98409-9026
(206) 327-8403
(206) 299-3342
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285311456
NPI
WA
Enumeration date
06/29/2023
Last updated
02/06/2025
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