Provider Demographics
NPI:1851404529
Name:YANASAK, ELISIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELISIA
Middle Name:
Last Name:YANASAK
Suffix:
Gender:F
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:MENTAL HEALTH SERVICE (A-116-ATC)
Mailing Address - Street 2:9600 VETERANS DR. S.W.
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98493-0001
Mailing Address - Country:US
Mailing Address - Phone:253-583-1661
Mailing Address - Fax:
Practice Address - Street 1:VA PSHCS, AMERICAN LK. DIV. (A-116-ATC)
Practice Address - Street 2:9600 VETERANS DR. S.W.
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493
Practice Address - Country:US
Practice Address - Phone:253-583-1661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002997103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical