Revamp Services Inc

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

REVAMP SERVICES INC

Doing business as

RevampDR
RevampDr LLC

Practice address

1702 S 72ND St Ste D
Tacoma, WA 98408-1238

Phone

(206) 327-8403

NPI assigned

Jun 29, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Grace Mwangi, DNP-FNP-CNPI 1740862804

Title

Ceo

Phone

(206) 327-8403

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• RevampDR Doing business as
• RevampDr LLC Doing business as

Locations

Practitioners 1

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

• Grace Mukami Mwangi, DNP-FNP

  • Primary Care Nurse Practitioner
  • Tacoma, WA
  • NPI 1740862804
  NPD Authorized official

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1285311456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7705 S JUNETT ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984099026",
            "telephone_number": "206-327-8403",
            "fax_number": "206-299-3342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 S 72ND ST STE D",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984081238",
            "telephone_number": "206-327-8403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7705 S Junett St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984099026",
            "country_code": "US",
            "telephone_number": "206-327-8403",
            "fax_number": "206-299-3342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVAMP SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-29",
        "last_updated": "2025-02-06",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "MWANGI",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "206-327-8403",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP-FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1285311456",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RevampDR",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RevampDr LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RevampDr LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Retina and Macula Specialists PS
• Gordon John Retterath Jr.
• Trenten Theodore Retzlaff
• Elizabeth Reum, B.A.
• Reunion Physical Therapy PS
• Revaxis LLC
• Felix Zeke Revelee, EMT
• Adilenne Reveles
• Revera (Delaware) LLC (Orchard Park Health and Rehabilitation Center)
• Stephen A Reville, MD

• Health Service Clinic/Center in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Health Service Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; 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.