Healthcare Provider Details

I. General information

NPI: 1154552024
Provider Name (Legal Business Name): WILLIAM JOESEL HS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2009
Last Update Date: 07/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 EDIZ HOOK
PORT ANGELES WA
98362-2201
US

IV. Provider business mailing address

1 EDIZ HOOK
PORT ANGELES WA
98362-0159
US

V. Phone/Fax

Practice location:
  • Phone: 360-417-5894
  • Fax: 360-417-5899
Mailing address:
  • Phone: 360-417-5894
  • Fax: 360-417-5899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: