Individual
MR. ELWOOD RAY KOENIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
WOODY KOENIG LCSW
Contact information
Practice address
319 W LOCUST AVE, HERMISTON, OR 97838-1734
(541) 567-3363
Mailing address
PO BOX 1546, HERMISTON, OR 97838-3546
(541) 567-3363
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
L1262
OR
101YM0800X
Mental Health Counselor
LW00006625
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83124000
BCBS REGENCE INSURANCE
OR
Enumeration date
05/20/2007
Last updated
07/08/2007
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