Healthcare Provider Details

I. General information

NPI: 1629324207
Provider Name (Legal Business Name): MAUREEN ONGOCO ESPARZA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAUREEN B ONGOCO

II. Dates (important events)

Enumeration Date: 08/01/2012
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1764 S 42ND ST
TACOMA WA
98418-1634
US

IV. Provider business mailing address

1764 S 42ND ST
TACOMA WA
98418-1634
US

V. Phone/Fax

Practice location:
  • Phone: 206-660-7545
  • Fax:
Mailing address:
  • Phone: 206-660-7545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60201582
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: