NPIMap

Organization Active NPI

Cloverhope Mental Health Services PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Federal Way, WA
National Provider Identifier
1104610658
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
CLOVERHOPE MENTAL HEALTH SERVICES PLLC
Practice address
32020 1St Ave S Ste 113
Federal Way, WA 98003-5743
Phone
(253) 600-4965
Fax
(253) 600-4960
NPI assigned
Apr 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Agnes Andal Maramba, NPNPI 1770158172
Title
NP- Owner
Phone
(253) 600-4965

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

32020 1St Ave S Ste 113
Federal Way, WA 98003-5743

Mailing address

32020 1St Ave S Ste 113
Federal Way, WA 98003-5743

Other practice location 1

32020 1st Ave S Ste 113
Federal Way, WA 98003-5743
Phone (253) 600-4965

Other practice location 2

32020 1st Ave S Ste 113
Federal Way, WA 98003-5743
Phone (253) 600-4965

Other names 1

  • CloverHope Mental Health Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250604003722 WA Part B Supplier - Clinic/Group Practice 0446769970 Receives reassigned benefits from 4 practitioners
Practice locations: Federal Way, WA

National Provider Directory

National Provider Directory
Tax ID family
Cloverhope Mental Health Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753747200000",
    "number": "1104610658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32020 1ST AVE S STE 113",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32020 1ST AVE S STE 113",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035743",
            "telephone_number": "253-600-4965",
            "fax_number": "253-600-4960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32020 1st Ave S Ste 113",
            "address_purpose": "LOCATION",
            "city": "Federal Way",
            "state": "WA",
            "postal_code": "980035743",
            "country_code": "US",
            "telephone_number": "253-600-4965",
            "fax_number": "253-600-4960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "32020 1st Ave S Ste 113",
            "address_purpose": "LOCATION",
            "city": "Federal Way",
            "state": "WA",
            "postal_code": "980035743",
            "country_code": "US",
            "telephone_number": "253-600-4965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CLOVERHOPE MENTAL HEALTH SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A",
        "authorized_official_last_name": "MARAMBA",
        "authorized_official_first_name": "AGNES",
        "authorized_official_middle_name": "ANDAL",
        "authorized_official_title_or_position": "NP- OWNER",
        "authorized_official_telephone_number": "253-600-4965",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CloverHope Mental Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.