Agnes Andal Maramba, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61625569 Issued in WA

Practice address

19435 68TH Ave S Ste S102
Kent, WA 98032-2114

Phone

(253) 414-1983

NPI assigned

May 26, 2021

Last updated

Feb 4, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Agnes Andal Reyes Other name

Medicare fee-for-service enrollment

Enrolled in CA, WA2 enrollments

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.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cloverhope Mental Health Services PLLC

  dba CloverHope Mental Health Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Federal Way, WA
  • NPI 1104610658
  Medicare reassignment NPD Authorized official
• Icare Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Kent, WA
  • NPI 1043021595
  Medicare reassignment NPD
• Progeny TMS Corporation

  • Mental Health Counselor
  • Irvine, CA
  • NPI 1558062265
  Medicare reassignment NPD
• Cloverhope Mental Health Services PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Federal Way, WA
  • NPI 1396614566
  NPD Authorized official

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1770158172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19435 68TH AVE S STE S102",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980322114",
            "telephone_number": "253-414-1983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19435 68TH AVE S STE S102",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980322114",
            "telephone_number": "253-414-1983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARAMBA",
        "first_name": "AGNES",
        "middle_name": "ANDAL",
        "name_prefix": "Miss",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-26",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61625569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AGNES",
            "last_name": "REYES",
            "middle_name": "ANDAL",
            "prefix": "MRS.",
            "credential": "NURSE PRACTITIONER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ibrahim Manshad
• Kooroush Mansourzadeh, D.D.S.
• Wesley Manzano, HCA
• Donna Manzo, LMP
• Wenlan Mao
• Oleksandr A Marchenko, LMP
• Margarita Marchuk
• Gary M. Marcus, PHD
• Mardix Pharmacy Inc
• Briana Elyse Marin, PT, DPT

• Psychiatric/Mental Health Nurse Practitioner in Kent, WA
• Providers in Kent, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.