Healthcare Provider Details

I. General information

NPI: 1659795425
Provider Name (Legal Business Name): TAMARRA ANGELIQUE GREENE LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAMARRA ANGELIQUE EVANS-SLUGA

II. Dates (important events)

Enumeration Date: 02/13/2014
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 S 19TH ST STE 200
TACOMA WA
98405-2961
US

IV. Provider business mailing address

PO BOX 5299 MS: 820-5-PCO
TACOMA WA
98415-0299
US

V. Phone/Fax

Practice location:
  • Phone: 253-697-8400
  • Fax: 253-697-8590
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9654442-6009
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61513110
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: