Provider Demographics
NPI:1427020684
Name:HOOFF, MAURICE GRANT (CRNA)
Entity Type:Individual
Prefix:
First Name:MAURICE
Middle Name:GRANT
Last Name:HOOFF
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37119 NE 86TH PL
Mailing Address - Street 2:
Mailing Address - City:LA CENTER
Mailing Address - State:WA
Mailing Address - Zip Code:98629-4249
Mailing Address - Country:US
Mailing Address - Phone:360-263-5211
Mailing Address - Fax:
Practice Address - Street 1:1615 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2310
Practice Address - Country:US
Practice Address - Phone:360-414-2000
Practice Address - Fax:360-575-6479
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006802163WX0002X
WAAP30003802367500000X
AZ226058367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9641697Medicaid
WA0203727OtherLABOR & IND
OR273978Medicaid
Q16156Medicare UPIN
WA9641697Medicaid