Healthcare Provider Details

I. General information

NPI: 1508661430
Provider Name (Legal Business Name): YOLANDA LONG GOFF, BS, CHHC, NBHWC, DPP HEALTH COACH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2025
Last Update Date: 02/14/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 208TH ST SE UNIT 3
BOTHELL WA
98012-7787
US

IV. Provider business mailing address

711 CAPITOL WAY S STE 204
OLYMPIA WA
98501-1267
US

V. Phone/Fax

Practice location:
  • Phone: 296-412-5458
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3240910
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: