Healthcare Provider Details

I. General information

NPI: 1992204754
Provider Name (Legal Business Name): TABITHA M YEAGER LMFT, MHP, CMHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TABITHA M HOOD LMFT, MHP, CMHS

II. Dates (important events)

Enumeration Date: 02/07/2018
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23801 E APPLEWAY AVE STE 110
LIBERTY LAKE WA
99019-9687
US

IV. Provider business mailing address

5620 N VISTA GRANDE DR
OTIS ORCHARDS WA
99027-9105
US

V. Phone/Fax

Practice location:
  • Phone: 509-869-7586
  • Fax: 509-903-1005
Mailing address:
  • Phone: 509-869-7586
  • Fax: 509-903-1005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF61182699
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: