Healthcare Provider Details

I. General information

NPI: 1568060085
Provider Name (Legal Business Name): VANESSA HONN, PHD, PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2020
Last Update Date: 09/04/2022
Certification Date: 09/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 N 2ND ST
TACOMA WA
98403-2232
US

IV. Provider business mailing address

2661 N PEARL ST STE 365
TACOMA WA
98407-2424
US

V. Phone/Fax

Practice location:
  • Phone: 253-237-4248
  • Fax: 253-201-9904
Mailing address:
  • Phone: 253-237-4248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VANESSA HONN
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PH.D.
Phone: 253-237-4248