Provider Demographics
NPI:1083648604
Name:VANDERHOEF, DAWN M (PHD, DNP, APRN)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:VANDERHOEF
Suffix:
Gender:F
Credentials:PHD, DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3857 MARTIN WAY E
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5268
Mailing Address - Country:US
Mailing Address - Phone:360-704-7170
Mailing Address - Fax:
Practice Address - Street 1:3857 MARTIN WAY E
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5268
Practice Address - Country:US
Practice Address - Phone:360-704-7170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNRN363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4136500OtherBCBS OF TENNESSEE
TNP00339426OtherRAILROAD MEDICARE
TN3348441Medicaid
TN4136500OtherBCBS OF TENNESSEE
TN3348440Medicare ID - Type UnspecifiedQUINCO MCR
TNP24731Medicare UPIN