Individual
MARY ANDREA GO UGADDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-5001
(253) 968-4801
Mailing address
901 S ORCHARD ST, TACOMA, WA 98465-2420
(908) 887-5298
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
565202
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
70027516
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/21/2005
Last updated
08/01/2025
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