Mystique Healthcare

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MYSTIQUE HEALTHCARE

Practice address

11541 6TH Ave E
Tacoma, WA 98445-8083

Phone

(206) 422-9443

NPI assigned

Jun 6, 2024

Organization subpart

No

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

Authorized official

Name

Luis Armando Lemus, NP

Title

Ceo

Phone

(206) 422-9443

Specialties & licenses 1

Addresses

Other names 1

• Mystique Healthcare Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Luis Armando Lemus Rodriguez, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Tacoma, WA
  • NPI 1851977706
  NPD

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1225879836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11541 6TH AVE E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984458083",
            "telephone_number": "206-422-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11541 6TH AVE E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984458083",
            "telephone_number": "206-422-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYSTIQUE HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "LEMUS",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "ARMANDO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "206-422-9443",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mystique Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mystique Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeremy S Myers
• Jordan H Myers
• Jenna Mylin, PA-C
• Pamela R Myricks-Orange Williams
• Vincent Mysliwiec, M.D.
• Edward Kyung-Rim NA, LMHCA
• Howard Benjamin Nabbefeld, VRC
• Karl Roa Nacalaban, PHARMD
• Connor Lavann Naccarato, DPT, MTC, CSCS
• Rosemary Clare Naccarato, DPT

• Mental Health Clinic/Center (Including Community Mental Health Center) in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.