Healthcare Provider Details

I. General information

NPI: 1841243052
Provider Name (Legal Business Name): GREGORY L. HOISINGTON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 03/07/2023
Certification Date: 02/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1780 NW MYHRE RD SUITE 2120
SILVERDALE WA
98383-8676
US

IV. Provider business mailing address

9621 RIDGETOP BLVD NW
SILVERDALE WA
98383-8502
US

V. Phone/Fax

Practice location:
  • Phone: 360-782-3101
  • Fax: 360-782-3141
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOP00001331
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: