Provider Demographics
NPI:1528822863
Name:SERENEMIND SOLUTIONS LLC
Entity type:Organization
Organization Name:SERENEMIND SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGALWA
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:206-915-6166
Mailing Address - Street 1:15127 MAIN ST E UNIT 104
Mailing Address - Street 2:PMB 231
Mailing Address - City:SUMNER
Mailing Address - State:WA
Mailing Address - Zip Code:98390-2689
Mailing Address - Country:US
Mailing Address - Phone:253-648-0340
Mailing Address - Fax:206-673-8050
Practice Address - Street 1:33530 1ST WAY S STE 102
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-7332
Practice Address - Country:US
Practice Address - Phone:206-915-6166
Practice Address - Fax:206-673-8050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty