Provider Demographics
NPI:1265124739
Name:YANNA, ELORA JEANNE
Entity type:Individual
Prefix:
First Name:ELORA
Middle Name:JEANNE
Last Name:YANNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELORA
Other - Middle Name:JEANNE
Other - Last Name:NEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2220 WESTRIDGE AVE W APT L303
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98466-1861
Mailing Address - Country:US
Mailing Address - Phone:360-500-7571
Mailing Address - Fax:
Practice Address - Street 1:1305 TACOMA AVE S STE 201
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-1903
Practice Address - Country:US
Practice Address - Phone:130-530-5984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor