Provider Demographics
NPI:1821404609
Name:HOVENIER, JACOB
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:
Last Name:HOVENIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 KENTUCKY ST # 391
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4200
Mailing Address - Country:US
Mailing Address - Phone:360-734-0363
Mailing Address - Fax:
Practice Address - Street 1:702 KENTUCKY ST # 391
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4200
Practice Address - Country:US
Practice Address - Phone:360-734-0363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor