Healthcare Provider Details

I. General information

NPI: 1598530081
Provider Name (Legal Business Name): MRS. YATTA DB HOHNBAUM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS YATTA D BARNETT

II. Dates (important events)

Enumeration Date: 11/15/2023
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11023 GRAVELLY LAKE DR SW
LAKEWOOD WA
98499-1331
US

IV. Provider business mailing address

930 CHATHAM DR SE
OLYMPIA WA
98513-7731
US

V. Phone/Fax

Practice location:
  • Phone: 503-704-5332
  • Fax:
Mailing address:
  • Phone: 503-704-5332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: