Individual
KIMBERLY IRENE HOAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
307 W COTA ST, SHELTON, WA 98584-2265
(503) 754-5467
Mailing address
326 CHOKER ST SE # B, LACEY, WA 98503-1529
(360) 491-9616
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/25/2019
Last updated
11/25/2019
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