Healthcare Provider Details

I. General information

NPI: 1275176547
Provider Name (Legal Business Name): NADIA MARIE OQUENDO AGNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2019
Last Update Date: 09/27/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 PACIFIC AVE STE 400
TACOMA WA
98402-4381
US

IV. Provider business mailing address

431 MERCEDES LN APT B
LAFAYETTE IN
47905-6602
US

V. Phone/Fax

Practice location:
  • Phone: 253-319-8146
  • Fax:
Mailing address:
  • Phone: 765-543-8237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP030820
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP61011723
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024190629
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLP-0010787
License Number StateDE
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2389336
License Number StateMA
# 6
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11028572
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15088700
License Number StateNJ
# 8
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704408499
License Number StateMI
# 9
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberN361012215
License Number StateWA
# 10
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13646
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: