MIND YOUR BODY CLINIC PLLC (NPI# 1306005525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306005525 |
| Entity Type | Organization |
| Organization Name | MIND YOUR BODY CLINIC PLLC |
| Practice Address |
3819 100th St Sw Suite 7-c Lakewood WA 98499-4470 |
| Mailing Address |
Po Box 97115 Lakewood WA 98497-0115 |
| Practice Telephone | 2535887911 |
| Practice Fax Number | 2539846774 |
| Mailing Telephone | 2535887911 |
| Mailing Fax Number | 2539846774 |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2008-06-03 |
| Authorized Official Name | DR. RAJNINDER K JUTLA (PROVIDER/OWNER) |
| Authorized Official Telephone | 2535887911 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | MD00047987 | WA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396044947 | Mind Your Body Clinic Pllc | Anesthesiology | 6900 E Greenlake Way N, Suite J, Seattle, WA 98103 | 2011-03-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | MIND YOUR BODY CLINIC PLLC | 6900 E Green Lake Way N Ste J, Ste J, Seattle, WA 98115-5480 |
| Street Address |
3819 100TH ST SW SUITE 7-C |
| City | LAKEWOOD |
| State | WA |
| Zip Code | 98499-4470 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003959891 | Makiko Guji | Psychologist | 3819 100th St Sw, Suite 7-c, Lakewood, WA 98499-4470 | 2007-02-14 |
| 1245462134 | Crescent Psychiatry Pllc | Psychologist | 3819 100th St Sw, Suite 7-c, Lakewood, WA 98499-4470 | 2009-08-11 |
| 1316181472 | Three Tree Infusion | Clinic/Center | 3819 100th St Sw, Suite 7-c, Lakewood, WA 98499-4470 | 2009-04-20 |
| 1396980900 | Chris Porter Arnp LLC | Registered Nurse | 3819 100th St Sw, Suite 7-c, Lakewood, WA 98499-4470 | 2008-12-10 |
| 1841441573 | Ldv Anesthesia Services LLC | Specialist | 3819 100th St Sw, Suite 7-c, Lakewood, WA 98499-4470 | 2008-09-30 |
| 1720237910 | Paceline Anesthesia LLC | Specialist | 3819 100th St Sw, Suite 7-c, Lakewood, WA 98499-4470 | 2008-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275159592 | Sea Mar Community Health Centers | Clinic/Center | 5700 100th Street Se, Suite 510, Lakewood, WA 98499 | 2020-06-23 |
| 1568018828 | Heather Leigh Andrade | Behavioral Analyst | 6210 75th St W Ste 100, Lakewood, WA 98499 | 2019-08-13 |
| 1043870876 | Seoul Chinese Herbs Inc | Acupuncturist | 8705 S. Tacoma Way, Lakewood, WA 98499 | 2019-06-14 |
| 1013572064 | Puget Sound Kidney Centers | Clinic/Center | 11950 47th Ave Sw, Lakewood, WA 98499 | 2019-05-06 |
| 1447736657 | Marcela Cunan | Counselor | 9330 59th Avenue Southest, Lakewood, WA 98499 | 2018-07-11 |
| 1609382381 | Leroy Moore IIi | Counselor | 8811 S. Tacoma Way, 106, Lakewood, WA 98499 | 2017-12-18 |
| 1578077657 | Andrea Gaston | Behavior Technician | 8815 S. Tacoma Way, Suite 122, Lakewood, WA 98499 | 2017-11-27 |
| 1609389931 | Jennifer King | Social Worker | 5900 100th St Sw Ste 17b, Lakewood, WA 98499 | 2017-11-08 |
| 1750806337 | Wonyoung Lee | Counselor | 8811 South Tacoma Way, Suite 106, Lakewood, WA 98499 | 2017-08-04 |
| 1043749443 | Frederick Paltron Edwards | Counselor | 9500 Front Street, Suite 100, Lakewood, WA 98499 | 2017-06-08 |
| Find all providers in zip 98499 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083199327 | Linnea Joy Wahlstrom-tarbet | Specialist | 8524 Steilacoom Blvd Sw Ste 201b, Lakewood, WA 98498-4772 | 2018-10-02 |
| 1790275857 | Sarah Freidman | Specialist | 371 Hope Chapel Rd, Lakewood, NJ 08701-2373 | 2018-05-15 |
| 1932639051 | Nj Mobile Medical, PC | Specialist | 105 River Ave Ste 103, Lakewood, NJ 08701-4267 | 2017-06-13 |
| 1104372168 | Shoshana Klein | Specialist | 128 Liberty Dr, Lakewood, NJ 08701-4137 | 2016-08-30 |
| 1467803601 | Allison Chancellor | Specialist | 467 S Reed Ct, Lakewood, CO 80226-3322 | 2016-06-29 |
| 1568811503 | Sora Zucker | Specialist | 38 Dena Ct, Lakewood, NJ 08701-3591 | 2016-06-10 |
| 1831559285 | Asia R Lundquist | Specialist | 8520 Steilacoom Blvd Sw Ste 101, Lakewood, WA 98498-4773 | 2016-02-28 |
| 1649640145 | Alejandra Martinez | Specialist | 7650 W Virginia Ave, Suite B, Lakewood, CO 80226-3131 | 2015-09-28 |
| 1225406127 | Chana Neustadt | Specialist | 154 Tudor Ct, Lakewood, NJ 08701-1471 | 2015-09-09 |
| 1194107979 | Suri Englard | Specialist | 38 Eagle Ln, Lakewood, NJ 08701-4967 | 2015-06-29 |
| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.