Rejuvenate Wellness Day Spa, PS

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

MA00023361 Issued in WA

Legal business name

REJUVENATE WELLNESS DAY SPA, PS

Doing business as

Wellness Day Spa

Practice address

7521 Bridgeport Way W Ste B
Lakewood, WA 98499-2423

Phone

(253) 503-7055

NPI assigned

Oct 23, 2012

Last updated

Oct 23, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Sung Ye Pak, MA00023361

Title

Vice President

Phone

(253) 503-7055

Specialties & licenses 1

Addresses

Other names 1

• Wellness Day Spa Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1124371497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88021",
            "city": "STEILACOOM",
            "state": "WA",
            "postal_code": "983880021",
            "telephone_number": "253-503-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7521 BRIDGEPORT WAY W STE B",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992423",
            "telephone_number": "253-503-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVENATE WELLNESS DAY SPA, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-23",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "PAK",
        "authorized_official_first_name": "SUNG YE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "253-503-7055",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA00023361"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "WA",
            "license": "MA00023361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness Day Spa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melanie Reichert, BS, SUDP
• Cheyenne Mary Reid, LMT
• Shenae Renee Reid, LPN
• Ukaesia Reid
• Sarah Jean Reisenauer, ARNP
• Erin Michaela Renard, COTA/L
• Renew Wellness Aesthetics PLLC
• Jerri Glenn Rennaker, B. A.
• Maleea Rennaker
• Renovation Biblical Counseling Services, PLLC

• Health Maintenance Organization in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Health Maintenance Organization in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.