MEDICARE: SAMANTHA HOKENSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1710387816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA HOKENSON

Provider Business Mailing Address
First Line	:	2211 S FAWN DR
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-3372
Country	:	US
Telephone Number	:	509-869-8884
Fax Number	:

Provider Business Practice Location Address
First Line	:	2211 S FAWN DR
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-3372
Country	:	US
Telephone Number	:	509-869-8884
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2014
Last Update Date	:	08/26/2014

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