Individual
DERRIK HUNTER MATTOX-HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 SE WASHINGTON AVE, CHEHALIS, WA 98532-3058
(360) 507-8032
Mailing address
PO BOX 141106, SPOKANE VALLEY, WA 99214-1106
(509) 232-5766
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG61605542
WA
Other
Enumeration date
03/06/2025
Last updated
03/06/2025
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