Healthcare Provider Details

I. General information

NPI: 1831965573
Provider Name (Legal Business Name): MONICA KOCH IHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 12/04/2023
Certification Date: 12/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14124 DOGWOOD CT NW
GIG HARBOR WA
98329-5516
US

IV. Provider business mailing address

14124 DOGWOOD CT NW
GIG HARBOR WA
98329-5516
US

V. Phone/Fax

Practice location:
  • Phone: 253-313-4916
  • Fax:
Mailing address:
  • Phone: 253-313-4916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: