Provider Demographics
NPI:1477446417
Name:GIG HARBOR MEDICAL SPA
Entity type:Organization
Organization Name:GIG HARBOR MEDICAL SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMOINE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP-FNP
Authorized Official - Phone:253-649-3916
Mailing Address - Street 1:11357 70TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-8073
Mailing Address - Country:US
Mailing Address - Phone:253-649-3916
Mailing Address - Fax:253-265-1219
Practice Address - Street 1:11515 BURNHAM DR STE 105
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-8543
Practice Address - Country:US
Practice Address - Phone:253-649-3916
Practice Address - Fax:253-265-1219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty