NPIMap

Organization Active NPI

Mind Your Body Clinic PLLC

  • Specialist
  • Lakewood, WA
National Provider Identifier
1306005525
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD00047987 Issued in WA
Legal business name
MIND YOUR BODY CLINIC PLLC
Practice address
3819 100TH St SW
Suite 7-C
Lakewood, WA 98499-4470
Phone
(253) 588-7911
Fax
(253) 984-6774
NPI assigned
Jun 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Authorized official

Name
Dr. Rajninder K Jutla, MD
Title
Provider/Owner
Phone
(253) 588-7911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MD00047987 WA Primary

Addresses

Primary practice location

3819 100TH St SW
Suite 7-C
Lakewood, WA 98499-4470

Mailing address

PO Box 97115
Lakewood, WA 98497-0115
Phone (253) 588-7911

National Provider Directory

National Provider Directory
Tax ID family
Mind Your Body Clinic PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1306005525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97115",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984970115",
            "telephone_number": "253-588-7911",
            "fax_number": "253-984-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3819 100TH ST SW",
            "address_2": "SUITE 7-C",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984994470",
            "telephone_number": "253-588-7911",
            "fax_number": "253-984-6774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND YOUR BODY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "JUTLA",
        "authorized_official_first_name": "RAJNINDER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "253-588-7911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00047987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; 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.