Organization
PHOENIX RISING WELLNESS CENTER
Active
Parent organization
PHOENIX RISING WELLNESS CENTER
Other names
Phoenix Rising Wellness Center of Lakewood
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX RISING WELLNESS CENTER
Authorized official
DR. SHAMIKA CORDIS DC (OWNER)
(360) 728-0315
Entity
Organization
Contact information
Practice address
11008 GRAVELLY LAKE DR SW, LAKEWOOD, WA 98499-1332
(253) 220-0711
(888) 317-8716
Mailing address
11008 GRAVELLY LAKE DR SW, LAKEWOOD, WA 98499-1332
(253) 220-0711
(888) 317-8716
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
225700000X
Massage Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH605050789
CHIROPRACTIC
—
Enumeration date
12/09/2020
Last updated
12/09/2020
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