=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548194640
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WILLIAM SCOTT KOENIG APRN
-----------------------------------------------------
Gender |
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/11/2026
-----------------------------------------------------
Last Update Date | 06/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 409 S MARKET BLVD STE 9
-----------------------------------------------------
City | CHEHALIS
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98532-3043
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-827-5362
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 753
-----------------------------------------------------
City | TOLEDO
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98591-0753
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-978-5925
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | ARNP.AP.70141126-NP
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------