Healthcare Provider Details

I. General information

NPI: 1669015152
Provider Name (Legal Business Name): RITA EVA ADELINA HOTCHKISS PEER COUNSELOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 MARTIN WAY E STE 117
OLYMPIA WA
98516-5586
US

IV. Provider business mailing address

505 SE ADAMS AVE
CHEHALIS WA
98532-3031
US

V. Phone/Fax

Practice location:
  • Phone: 360-413-6910
  • Fax: 360-413-9026
Mailing address:
  • Phone: 360-266-5024
  • Fax: 360-359-7737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number60783153
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number61028914
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: