Healthcare Provider Details

I. General information

NPI: 1548052590
Provider Name (Legal Business Name): MS. EKAETE E OKON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

748 MARKET ST # 225
TACOMA WA
98402-3737
US

IV. Provider business mailing address

5826 NEW TERRITORY BLVD # 922
SUGAR LAND TX
77479-5948
US

V. Phone/Fax

Practice location:
  • Phone: 713-658-5720
  • Fax:
Mailing address:
  • Phone: 713-658-5720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1046157
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberC-APN.0104354-C-NP
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP70009507
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number85234
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: