Organization
DADS MOVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NELSON RASCON MPA (EXECUTIVE DIRECTOR)
(253) 230-3558
Entity
Organization
Contact information
Practice address
12108 PACIFIC AVE S, TACOMA, WA 98444-5125
(253) 230-3558
Mailing address
12108 PACIFIC AVE S, TACOMA, WA 98444-5125
(253) 230-3558
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
04/03/2025
Last updated
04/03/2025
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