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Individual

ERICA RAE HAUSCHULZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1623 5TH STREET, CLARKSTON, WA 99403
(509) 758-3341
Mailing address
900 7TH STREET, CLARKSTON, WA 99403-2005
(509) 758-3341

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
175T00000X
Peer Specialist
Primary
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
91-1156943
WA
Enumeration date
10/05/2018
Last updated
01/19/2022
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