Organization
PUYALLUP TRIBAL OPIOID CLINIC, INC.
Active
Other names
Cedar Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT LOUIS KERSHNER (MANAGER)
(303) 859-2742
Entity
Organization
Contact information
Practice address
503 EAST 26TH ST, TACOMA, WA 98421
(253) 881-7001
Mailing address
6650 GUNPARK DR STE 100, BOULDER, CO 80301-7003
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
09/14/2023
Last updated
03/07/2024
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