Individual
JUSTUS MBOGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
4007 BRIDGEPORT WAY W STE B, UNIVERSITY PLACE, WA 98466-4330
(972) 369-8869
Mailing address
812 W MCDERMOTT DR # 1004, ALLEN, TX 75013-6500
(972) 369-8869
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP70065404
WA
Other
Enumeration date
01/29/2026
Last updated
01/29/2026
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