Individual provider Active NPI

Ugonna Ejindu, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Issaquah, WA
National Provider Identifier
1508697392
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP70016697 Issued in WA
Practice address
371 NE Gilman Blvd Ste 160
Issaquah, WA 98027-2901
Phone
(615) 601-0857
NPI assigned
Aug 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 36057 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X L8-0010646 DE
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP70016697 WA Primary

Addresses

Primary practice location

371 NE Gilman Blvd Ste 160
Issaquah, WA 98027-2901

Mailing address

307 N University Blvd
Mobile, AL 36688-3053
Phone (870) 316-1832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2009 Leefield Dr
Antioch, TN 37013-3986

500 Westover Dr
Sanford, NC 27330-8941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L8-0010646DEMDPsychiatric/Mental Health Nurse Practitioner
AP70016697WAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1508697392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 N UNIVERSITY BLVD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366883053",
            "telephone_number": "870-316-1832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 NE GILMAN BLVD STE 160",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272901",
            "telephone_number": "615-601-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJINDU",
        "first_name": "UGONNA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "36057",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "L8-0010646",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP70016697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

Verify at the official NPI Registry.