Healthcare Provider Details

I. General information

NPI: 1073047726
Provider Name (Legal Business Name): REBECCA HOFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 04/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2723 SUNSET CT
STEILACOOM WA
98388-2817
US

IV. Provider business mailing address

2723 SUNSET CT
STEILACOOM WA
98388-2817
US

V. Phone/Fax

Practice location:
  • Phone: 253-564-4135
  • Fax:
Mailing address:
  • Phone: 253-564-4135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF00001199
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: