Organization
PACIFIC LUTHERAN UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUTH M KOHLER (OFFICE MANAGER)
(253) 535-8753
Entity
Organization
Contact information
Practice address
12108 PACIFIC AVENUE PACIFIC LUTHERAN UNIVERSITY, EAST CAMPUS, SUITE G-10, TACOMA, WA 98447-0003
(253) 535-7354
(253) 535-7071
Mailing address
12108 PACIFIC AVENUE PACIFIC LUTHERAN UNIVERSITY, EAST CAMPUS, SUITE G-10, TACOMA, WA 98447-0003
(253) 535-7354
(253) 535-7071
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0115931
LABOR AND INDUSTRIES
WA
05
—
7043656
—
WA
01
—
AL1346
REGENCE GROUP #
WA
Enumeration date
11/07/2006
Last updated
08/22/2020
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