Provider Demographics
NPI:1144389529
Name:YOUNKER, STEPHEN ALLEN (EDD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ALLEN
Last Name:YOUNKER
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 S 40TH AVE
Mailing Address - Street 2:22
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-3806
Mailing Address - Country:US
Mailing Address - Phone:509-966-5685
Mailing Address - Fax:509-966-5731
Practice Address - Street 1:1015 S 40TH AVE
Practice Address - Street 2:22
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-3806
Practice Address - Country:US
Practice Address - Phone:509-966-5685
Practice Address - Fax:509-966-5731
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPSY000732103TC0700X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGOOO119431Medicare ID - Type Unspecified