Hoda Tabatabaei-Moghaddam

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

60996653 Issued in WA

Practice address

7202 NE Highway 99 Ste 106-4392
Vancouver, WA 98665-8932

Phone

(253) 501-6019

NPI assigned

Nov 12, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Children'S Home Society of Washington

  • Community/Behavioral Health Agency
  • Vancouver, WA
  • NPI 1063566867
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1396118360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7202 NE HIGHWAY 99 STE 106-4392",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986658932",
            "telephone_number": "253-501-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7202 NE HIGHWAY 99 STE 106-4392",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986658932",
            "telephone_number": "253-501-6019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2406 NE 139th St Apt V-208",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986862768",
            "country_code": "US",
            "telephone_number": "253-501-6019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABATABAEI-MOGHADDAM",
        "first_name": "HODA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-12",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "60996653",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "60996653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Aurita Estudillo Tagle, NAR (GRANDFATHERED)
• Brittney Taisacan-Vilante

• Marriage & Family Therapist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.