Healthcare Provider Details

I. General information

NPI: 1508222019
Provider Name (Legal Business Name): DEBORAH HOENIG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2016
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21610 PACIFIC WAY
OCEAN PARK WA
98640-3206
US

IV. Provider business mailing address

105 HOENIG DR
CULLMAN AL
35055-5293
US

V. Phone/Fax

Practice location:
  • Phone: 360-665-3000
  • Fax: 360-665-3096
Mailing address:
  • Phone: 256-507-0282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-117440
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60911804
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: