Provider Demographics
NPI:1427388859
Name:HATFIELD, DEREK R (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEREK
Middle Name:R
Last Name:HATFIELD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 HENNESSY RD
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-9533
Mailing Address - Country:US
Mailing Address - Phone:724-541-2701
Mailing Address - Fax:
Practice Address - Street 1:520 HENNESSY RD
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-9533
Practice Address - Country:US
Practice Address - Phone:724-541-2701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-07
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY61150763103T00000X
PAPS016690103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist