Provider Demographics
NPI:1265150478
Name:HERAMBA MENTAL HEALTHCARE, PLLC
Entity type:Organization
Organization Name:HERAMBA MENTAL HEALTHCARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TCHIDO
Authorized Official - Middle Name:
Authorized Official - Last Name:YAO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:888-867-0204
Mailing Address - Street 1:1314 CENTRAL AVE S STE 203
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-7430
Mailing Address - Country:US
Mailing Address - Phone:888-867-0204
Mailing Address - Fax:888-867-2165
Practice Address - Street 1:1314 CENTRAL AVE S STE 203
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-7430
Practice Address - Country:US
Practice Address - Phone:888-867-0204
Practice Address - Fax:888-867-2165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty