IndividualActive
Jody Genuard, NC10062045
NPI 1790038420 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Lakewood, WA
Provider details
- NPI number
- 1790038420
- Entity type
- Individual
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Credential
- NC10062045
- Sex
- Female
- Sole proprietor
- Yes
- License
- NC 10062045 (WA)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityPrimary320600000XLicense NC 10062045 (WA)
Residential Treatment Facilities
Practice location
9330 59th Ave Sw
Lakewood, WA 98499-2858
Phone: (253) 298-9141
Approximate (ZIP-level) locationGet directions
Mailing address
9330 59th Avenue Southwest
Lakewood, WA 98499
Registry dates
- Enumerated
- 2012-10-18
- Last updated
- 2012-10-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.