Provider Demographics
NPI:1245793884
Name:HOFFMANN, ELIZABETTH IRENE
Entity Type:Individual
Prefix:
First Name:ELIZABETTH
Middle Name:IRENE
Last Name:HOFFMANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1474 E MASON AVE
Mailing Address - Street 2:
Mailing Address - City:BUCKLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98321-9648
Mailing Address - Country:US
Mailing Address - Phone:253-370-9764
Mailing Address - Fax:
Practice Address - Street 1:1474 E MASON AVE
Practice Address - Street 2:
Practice Address - City:BUCKLEY
Practice Address - State:WA
Practice Address - Zip Code:98321-9648
Practice Address - Country:US
Practice Address - Phone:253-569-2073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer