Healthcare Provider Details

I. General information

NPI: 1568231066
Provider Name (Legal Business Name): ERIN L KOCH - PROPP CIWS, ACC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2023
Last Update Date: 12/27/2023
Certification Date: 12/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 77TH TRL SE
TUMWATER WA
98501-5847
US

IV. Provider business mailing address

1225 77TH TRL SE
TUMWATER WA
98501-5847
US

V. Phone/Fax

Practice location:
  • Phone: 360-292-8142
  • Fax:
Mailing address:
  • Phone: 360-292-8142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: