Healthcare Provider Details

I. General information

NPI: 1093688384
Provider Name (Legal Business Name): HOH INDIAN TRIBE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2263 LOWER HOH RD
FORKS WA
98331
US

IV. Provider business mailing address

PO BOX 2196
FORKS WA
98331
US

V. Phone/Fax

Practice location:
  • Phone: 360-374-6582
  • Fax: 360-374-5426
Mailing address:
  • Phone: 360-374-6582
  • Fax: 360-374-5426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. DARLENE HOLLUM
Title or Position: CHAIRWOMAN
Credential:
Phone: 360-780-0459