Provider Demographics
NPI:1699208298
Name:MASSEY, YOLONDA
Entity Type:Individual
Prefix:
First Name:YOLONDA
Middle Name:
Last Name:MASSEY
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 1:1529 202ND STREET CT E
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-1825
Mailing Address - Country:US
Mailing Address - Phone:253-262-9100
Mailing Address - Fax:
Practice Address - Street 1:5324 84TH ST E
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98446-5627
Practice Address - Country:US
Practice Address - Phone:253-446-6630
Practice Address - Fax:253-322-7694
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF61050559106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist