Derrik Hunter Mattox-Hanson
Counselor in Chehalis, WA. Individual provider (NPI-1).
NPI number1245038017
StatusActive
Last updated in NPPESMar 6, 2025
Details
- NPI
- 1245038017
- Entity type
- Individual (NPI-1)
- Name
- Derrik Hunter Mattox-Hanson
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 6, 2025
- Certification date
- Mar 6, 2025
- Last updated
- Mar 6, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | CG61605542 | WA | Yes |
Practice location
500 Se Washington AveChehalis, WA 98532-3058
Phone 360-507-8032
Mailing address
Po Box 141106Spokane Valley, WA 99214-1106
Phone 509-232-5766
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