Provider Demographics
NPI:1568549160
Name:HOKANSON, LINDA J (RD, CD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:HOKANSON
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:J
Other - Last Name:JASTAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:820 N CHELAN AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2028
Mailing Address - Country:US
Mailing Address - Phone:509-663-8711
Mailing Address - Fax:
Practice Address - Street 1:820 N CHELAN AVE
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2028
Practice Address - Country:US
Practice Address - Phone:509-663-8711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00001412133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0275884OtherL&I
WAP01082389OtherRR MEDICARE
WA2011408Medicaid
WA2011408Medicaid
WAG892438Medicare PIN