DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JODY LYN GENUARD, NC10062045

Active Sole Proprietor

Intellectual Disabilities Residential Treatment Facility · LAKEWOOD, WA

Registration Details

NPI Number
1790038420
Provider Type
Individual
Gender
Female
NPI Issued
Oct 18, 2012 (13.508714900639 yrs)
Last Updated
Oct 18, 2012
License
NC 10062045 (WA)
Sole Proprietor
Yes

Practice Information

Address
9330 59TH AVE SW
LAKEWOOD, WA, 984992858
Browse WA providers · Browse ZIP 98499
Phone
2532989141
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.