Healthcare Provider Details

I. General information

NPI: 1225964208
Provider Name (Legal Business Name): MOLLY ELLEN ZINKLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 MAPLE ST
HOQUIAM WA
98550-2113
US

IV. Provider business mailing address

1012 MAPLE ST
HOQUIAM WA
98550-2113
US

V. Phone/Fax

Practice location:
  • Phone: 360-581-4847
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMHCA.MC.70073482
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: