Organization · Type 2 NPI

Phoenix Rising Wellness Center

Chiropractor · Lakewood, WA

NPI number 1639775174 Active

Practice location

11008 Gravelly Lake Dr SW
Lakewood, WA 98499-1332

Fax (888) 317-8716

Specialties and licenses

Taxonomy	Code	License
Chiropractor Primary	111N00000X	None listed
Massage Therapist	225700000X	None listed

Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Another provider at this address

Clyde O. McDade, LMTMassage Therapist Lakewood, WA NPI 1982680815

Other chiropractor providers in Lakewood

See all in Lakewood →

NPI record

NPI: 1639775174
Entity type: Organization (Type 2)
Issued: Dec 9, 2020
Last updated: Dec 9, 2020
Status: Active
Subpart: Yes of Phoenix Rising Wellness Center

Other names

Phoenix Rising Wellness Center of Lakewood · other name

Authorized official

Dr. Shamika Cordis, DC
Owner
(360) 728-0315

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1639775174

Phoenix Rising Wellness Center's National Provider Identifier is 1639775174, issued on Dec 9, 2020. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Lakewood, WA. The record was last updated on Dec 9, 2020.