Healthcare Provider Details

I. General information

NPI: 1497054241
Provider Name (Legal Business Name): HANNAH NOELLE DEZONIA FARMER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2011
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16550 177TH AVE SE
MONROE WA
98272-1968
US

IV. Provider business mailing address

16550 177TH AVE SE
MONROE WA
98272-1968
US

V. Phone/Fax

Practice location:
  • Phone: 360-794-2400
  • Fax:
Mailing address:
  • Phone: 360-794-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61524151
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: