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Individual

JOANNE E KOOISTRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
600 BROADWAY ST, LONGVIEW, WA 98632-3256
(360) 414-2236
(360) 414-2788
Mailing address
PO BOX 249, LONGVIEW, WA 98632-7154
(360) 414-2000

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW60084292
WA

Other

Enumeration date
05/12/2009
Last updated
04/22/2010
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