Healthcare Provider Details

I. General information

NPI: 1548194640
Provider Name (Legal Business Name): WILLIAM SCOTT KOENIG APRN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 S MARKET BLVD STE 9
CHEHALIS WA
98532-3043
US

IV. Provider business mailing address

PO BOX 753
TOLEDO WA
98591-0753
US

V. Phone/Fax

Practice location:
  • Phone: 360-827-5362
  • Fax:
Mailing address:
  • Phone: 360-978-5925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP.AP.70141126-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: