Provider Demographics
NPI:1235274788
Name:HURST, JOSHUA LEE (BS)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:LEE
Last Name:HURST
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 61
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:WA
Mailing Address - Zip Code:99166-0061
Mailing Address - Country:US
Mailing Address - Phone:509-775-0930
Mailing Address - Fax:
Practice Address - Street 1:42 KLONDIKE RD
Practice Address - Street 2:
Practice Address - City:REPUBLIC
Practice Address - State:WA
Practice Address - Zip Code:99166-9701
Practice Address - Country:US
Practice Address - Phone:509-775-3341
Practice Address - Fax:509-775-8906
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00056108101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health