Healthcare Provider Details

I. General information

NPI: 1366370454
Provider Name (Legal Business Name): HOPE IN HIS HANDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2209 COOKS HILL RD
CENTRALIA WA
98531-9076
US

IV. Provider business mailing address

2209 COOKS HILL RD
CENTRALIA WA
98531-9076
US

V. Phone/Fax

Practice location:
  • Phone: 775-685-9913
  • Fax:
Mailing address:
  • Phone: 775-685-9913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHANNON VEGA
Title or Position: OWNER
Credential: LICSW
Phone: 775-685-9913