Provider Demographics
NPI:1508948555
Name:HO, PHOEBE F (MD)
Entity Type:Individual
Prefix:DR
First Name:PHOEBE
Middle Name:F
Last Name:HO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 S 56TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-6902
Mailing Address - Country:US
Mailing Address - Phone:253-475-1885
Mailing Address - Fax:253-472-8473
Practice Address - Street 1:2115 S 56TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-6902
Practice Address - Country:US
Practice Address - Phone:253-475-1885
Practice Address - Fax:253-472-8473
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00038873207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1116532Medicaid
WAGAB34975Medicare ID - Type Unspecified
WA1116532Medicaid