MEDICARE: DAWN M VANDERHOEF PHD, DNP, APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN	MN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00339426	OTHER	TN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4136500	OTHER	TN	BCBS OF TENNESSEE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083648604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN M VANDERHOEF PHD, DNP, APRN

Provider Business Mailing Address
First Line	:	3857 MARTIN WAY E
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98506-5268
Country	:	US
Telephone Number	:	360-704-7170
Fax Number	:

Provider Business Practice Location Address
First Line	:	3857 MARTIN WAY E
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98506-5268
Country	:	US
Telephone Number	:	360-704-7170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	12/16/2022

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