Provider Demographics
NPI:1083495790
Name:HOHNSTEIN-VAN ETTEN, ERICK (MSW)
Entity Type:Individual
Prefix:
First Name:ERICK
Middle Name:
Last Name:HOHNSTEIN-VAN ETTEN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:ERICK
Other - Middle Name:
Other - Last Name:HOHNSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1716 S CUSHMAN AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-3534
Mailing Address - Country:US
Mailing Address - Phone:360-620-3809
Mailing Address - Fax:
Practice Address - Street 1:3436 MARY ELDER RD NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5050
Practice Address - Country:US
Practice Address - Phone:360-528-2590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health