Healthcare Provider Details

I. General information

NPI: 1346064714
Provider Name (Legal Business Name): TENAJE SAM MA-P
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TOGETHERNESS MOBILE HEALTH MA-P

II. Dates (important events)

Enumeration Date: 11/13/2024
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2341 S J ST
TACOMA WA
98405-3831
US

IV. Provider business mailing address

2341 S J ST
TACOMA WA
98405-3831
US

V. Phone/Fax

Practice location:
  • Phone: 253-973-1623
  • Fax:
Mailing address:
  • Phone: 253-973-1623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberPC60635715
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number60635715
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberPC60635715
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: