Healthcare Provider Details

I. General information

NPI: 1336001817
Provider Name (Legal Business Name): EUGENA LOUISE HINTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 E PLUM ST
MOSES LAKE WA
98837-1874
US

IV. Provider business mailing address

840 E PLUM ST
MOSES LAKE WA
98837-1874
US

V. Phone/Fax

Practice location:
  • Phone: 509-765-9239
  • Fax: 509-297-7912
Mailing address:
  • Phone: 509-765-9239
  • Fax: 509-297-7912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: