| Emerald City Health | |
|
11421 Pacific Hwy Sw Lakewood WA 98499 | |
| (253) 352-0481 | |
| (253) 212-0360 |
| Full Name | Emerald City Health |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 11421 Pacific Hwy Sw, Lakewood, Washington |
| Authorized Official Name and Position | Claudia A Johnson (ADMINISTRATOR/OPERATOR) |
| Authorized Official Contact | 2533520481 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerald City Health Po Box 39460 Lakewood WA 98496 Ph: (253) 352-0481 | Emerald City Health 11421 Pacific Hwy Sw Lakewood WA 98499 Ph: (253) 352-0481 |
| NPI Number | 1184311011 |
|---|---|
| Provider Enumeration Date | 04/20/2023 |
| Last Update Date | 04/26/2023 |
| Certification Date | 04/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184311011 | NPI | - | NPPES |
| PO2225854 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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