Healthcare Provider Details

I. General information

NPI: 1992490460
Provider Name (Legal Business Name): MARGARET OGRADY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 MARTIN LUTHER KING JR. WAY MAILSTOP 315-5C-TFM
TACOMA WA
98405
US

IV. Provider business mailing address

315 MARTIN LUTHER KING JR. WAY MAILSTOP 315-5C-TFM
TACOMA WA
98405
US

V. Phone/Fax

Practice location:
  • Phone: 253-792-6680
  • Fax: 253-403-2915
Mailing address:
  • Phone: 253-792-6680
  • Fax: 253-403-2915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: