Healthcare Provider Details

I. General information

NPI: 1023791175
Provider Name (Legal Business Name): VANESSA MARIE HOFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S VALLEY VIEW BLVD FL 2
LAS VEGAS NV
89107-4448
US

IV. Provider business mailing address

903 9TH AVE APT 47
SEATTLE WA
98104-1250
US

V. Phone/Fax

Practice location:
  • Phone: 702-815-9012
  • Fax:
Mailing address:
  • Phone: 425-830-1566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: