Provider Demographics
NPI:1356682702
Name:HOEGER, STACIE MICHELLE
Entity Type:Individual
Prefix:MRS
First Name:STACIE
Middle Name:MICHELLE
Last Name:HOEGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 N WALL ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-6104
Mailing Address - Country:US
Mailing Address - Phone:541-400-8274
Mailing Address - Fax:
Practice Address - Street 1:7505 N WALL ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-6104
Practice Address - Country:US
Practice Address - Phone:541-400-8274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians