Provider Demographics
NPI:1255939278
Name:HOYER, JONATHAN MARK (LSWAIC)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:MARK
Last Name:HOYER
Suffix:
Gender:M
Credentials:LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6119 BUCKTHORN CT NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-3434
Mailing Address - Country:US
Mailing Address - Phone:916-413-5268
Mailing Address - Fax:
Practice Address - Street 1:908 5TH AVE SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1507
Practice Address - Country:US
Practice Address - Phone:360-754-2423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-12
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC611241491041C0700X
WACG61114074101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical