Provider Demographics
NPI:1174895650
Name:TULIAO, ANDREA MOLINE-MYGATT (LICSW)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:MOLINE-MYGATT
Last Name:TULIAO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:GLARNER, MOLINE, MOLINE-MYGATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19174 133RD ST E
Mailing Address - Street 2:
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391-5505
Mailing Address - Country:US
Mailing Address - Phone:314-917-1383
Mailing Address - Fax:
Practice Address - Street 1:9505 S STEELE ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-1858
Practice Address - Country:US
Practice Address - Phone:253-597-6800
Practice Address - Fax:253-597-6888
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator