Organization
PRESTIGE MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILLICENT MBUA NP (PRESIDENT)
(253) 293-0683
Entity
Organization
Contact information
Practice address
7720 190TH AVE E, BONNEY LAKE, WA 98391-7010
(253) 293-0683
(253) 397-4640
Mailing address
7720 190TH AVE E, BONNEY LAKE, WA 98391-7010
(253) 293-0683
(253) 397-4640
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/08/2024
Last updated
03/08/2024
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