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General NPI Number Information
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NPI Number | 1811734122
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Entity Type | Individual
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Provider Name | PERAS HODGKIN
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Gender | Female
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Dates
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Enumeration Date | 07/12/2024
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 6221 NE FOURTH PLAIN BLVD APT 130
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City | VANCOUVER
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State | WA
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Zip | 98661-7210
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Country | US
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Telephone | 360-831-0908
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Fax |
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Provider Business Mailing Address
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Address Line | 1915 W 31ST ST APT G
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City | VANCOUVER
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State | WA
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Zip | 98660-1276
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Country | US
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Telephone | 360-784-4052
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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