Lifestyle Community Clinic a Nonprofit Corporation

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

LIFESTYLE COMMUNITY CLINIC A NONPROFIT CORPORATION

Practice address

4545 S Union Ave
Tacoma, WA 98409-4532

Phone

(253) 732-3573

NPI assigned

Jan 24, 2024

Organization subpart

No

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

Authorized official

Name

Esther M Park Hwang, MDNPI 1184638439

Title

Medical Director

Phone

(253) 732-3573

Specialties & licenses 7

Addresses

Other names 1

• PNW Wellness Partners Former legal business name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 2

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

• Esther M Park-Hwang, MD

  • Obstetrics & Gynecology Physician
  • Tacoma, WA
  • NPI 1184638439
  Medicare reassignment NPD Authorized official
• F Patricia Glynis McEachrane-Gross, MD MPH

  • Family Medicine Physician
  • Ocala, FL
  • NPI 1417038894
  NPD (past)

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

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1831951979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 S UNION AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984094532",
            "telephone_number": "253-732-3573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 S UNION AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984094532",
            "telephone_number": "253-732-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE COMMUNITY CLINIC A NONPROFIT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "PARK HWANG",
        "authorized_official_first_name": "ESTHER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "253-732-3573",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QB0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Birthing",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PNW Wellness Partners",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "PNW Wellness Partners",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Teri Jo Lientz, P.T., A.T.C.
• Katherine Bibb Liesemer, M.D.
• Kirk N. Liesemer, M.D.
• Kenneth Lieuw, MD, PHD
• Life Transitions L.L.C.
• Lifeview Medical LLC
• Jacob Light, M.D.
• Jeanie Marie Lightfoot, CRNA
• Donald Lillegard, MD
• Ka'Nysha Lilly

• Obstetrics & Gynecology Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Obstetrics & Gynecology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.