Individual
AMANDA G HOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
646 S STATE ST, TACOMA, WA 98405-3036
(253) 227-3571
Mailing address
646 S STATE ST, TACOMA, WA 98405-3036
(253) 227-3571
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
60180023
WA
Other
Enumeration date
09/12/2013
Last updated
09/12/2013
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