Healthcare Provider Details

I. General information

NPI: 1942953245
Provider Name (Legal Business Name): TESSA HOVEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2022
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4254 JACKSON HWY
CHEHALIS WA
98532-8424
US

IV. Provider business mailing address

179 BRADY LN
WINLOCK WA
98596-9368
US

V. Phone/Fax

Practice location:
  • Phone: 360-996-6603
  • Fax: 360-996-6604
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60480893
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: