Healthcare Provider Details

I. General information

NPI: 1588601181
Provider Name (Legal Business Name): KELLY HOFFERBER AU.D, CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7105 W HOOD PL STE A103
KENNEWICK WA
99336-6714
US

IV. Provider business mailing address

805 MADISON ST STE 901
SEATTLE WA
98104-1172
US

V. Phone/Fax

Practice location:
  • Phone: 509-735-5551
  • Fax: 509-735-5552
Mailing address:
  • Phone: 509-735-5551
  • Fax: 509-735-5552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberLD00002175
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License NumberLD00002175
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberLD00002175
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: