Provider Demographics
NPI:1649562695
Name:MEDICINAL ALTERNATIVE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:MEDICINAL ALTERNATIVE SOLUTIONS, LLC
Other - Org Name:MAS CARE MEDICAL CENTER OF TACOMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NOOR
Authorized Official - Middle Name:FALESTEEN
Authorized Official - Last Name:SAID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-507-7548
Mailing Address - Street 1:2602 S 38TH ST
Mailing Address - Street 2:PMB 359
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-7303
Mailing Address - Country:US
Mailing Address - Phone:253-507-7548
Mailing Address - Fax:253-507-7614
Practice Address - Street 1:3716 PACIFIC AVE
Practice Address - Street 2:SUITE H
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98418-7836
Practice Address - Country:US
Practice Address - Phone:253-507-7548
Practice Address - Fax:888-978-7773
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICINAL ALTERNATIVE SOLUTIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00018311207R00000X
WAAP60169377364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult HealthGroup - Multi-Specialty