Provider Demographics
NPI:1134213465
Name:HOHMAN, LAUREN
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:HOHMAN
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 1:314 S 11TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3212
Mailing Address - Country:US
Mailing Address - Phone:509-902-3212
Mailing Address - Fax:
Practice Address - Street 1:314 S 11TH AVE STE A
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3212
Practice Address - Country:US
Practice Address - Phone:509-902-8585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10003322363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA137348OtherL & I
7991OtherGROUP HEALTH
WA8196354Medicaid
WA9080HOOtherREGENCE
911019392OtherCOMMERCIAL
WA8196354OtherCHPW
WA8196354OtherCHPW
P32738Medicare UPIN
GAB22222Medicare ID - Type Unspecified