National Provider Identifier Database

FOUNTAIN OF LIFE WELLNESS CENTER
Voluntary or Charitable


Contact Information

FOUNTAIN OF LIFE WELLNESS CENTER
1314 72ND ST E
TACOMA, WA98404-3343
Phone: 253-380-5263
Fax:
Website:
Specialty Taxonomy Code
* Voluntary or Charitable 251V00000X

* Indicates primary specialty

NPI Profile & details for FOUNTAIN OF LIFE WELLNESS CENTER

NPI Number 1558672329
Legal business name
LBN
FOUNTAIN OF LIFE WELLNESS CENTER
Authorized official BRENDA MILEWSKI - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 06/27/2010
Last updated 06/27/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • WA License #: 602786502

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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