Jalisa Genelle Mustin | Tacoma, WA • PECOS Search

Jalisa Genelle Mustin

Counselor

Behavioral Health & Social Service Providers

1201 S Proctor St, Tacoma, WA 98405-2047

PECOS Enrollment

Based on the most recent information from CMS, provider Jalisa Genelle Mustin does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1841001682
Provider Type
Individual
Full Name
Mustin, Jalisa Genelle
Gender
Female

Sole Proprietor
No
Enumeration Date
1/20/2025
Last Updated
1/20/2025

Contact Information

Practice Location

1201 S Proctor St, Tacoma, WA 98405-2047

Unlisted Fax

Mailing Location

1201 S Proctor St, Tacoma, WA 98405-2047

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer