Provider Demographics
NPI:1154383917
Name:GAROUTTE, YOLANDA EVELYN (PA-C)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:EVELYN
Last Name:GAROUTTE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:YOLANDA
Other - Middle Name:EVELYN
Other - Last Name:MARTIN COTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:209 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4265
Mailing Address - Country:US
Mailing Address - Phone:253-596-3300
Mailing Address - Fax:
Practice Address - Street 1:209 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4265
Practice Address - Country:US
Practice Address - Phone:253-596-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03103363AS0400X
WAPA61031690363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y5293OtherBCBS
P58161Medicare UPIN
TXMA08E0525Medicare ID - Type Unspecified