=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093688384
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOH INDIAN TRIBE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/24/2025
-----------------------------------------------------
Last Update Date | 09/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2263 LOWER HOH RD
-----------------------------------------------------
City | FORKS
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98331
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-374-6582
-----------------------------------------------------
Fax | 360-374-5426
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2196
-----------------------------------------------------
City | FORKS
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98331
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-374-6582
-----------------------------------------------------
Fax | 360-374-5426
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHAIRWOMAN
-----------------------------------------------------
Name | MRS. DARLENE HOLLUM
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 360-780-0459
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------