Provider Demographics
NPI:1811492440
Name:BULEGA-KASAGGA, MARY K (ARNP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:K
Last Name:BULEGA-KASAGGA
Suffix:
Gender:
Credentials:ARNP
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2302 S UNION AVE STE C26
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1334
Mailing Address - Country:US
Mailing Address - Phone:425-444-2314
Mailing Address - Fax:253-981-0922
Practice Address - Street 1:2302 S UNION AVE STE C26
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1334
Practice Address - Country:US
Practice Address - Phone:425-444-2314
Practice Address - Fax:253-981-0922
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60818755363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2100459Medicaid