Provider Demographics
NPI:1881443620
Name:HOAGLAND, TRISHA MARIE (LICSW)
Entity type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:MARIE
Last Name:HOAGLAND
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 LISEL LN
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-7228
Mailing Address - Country:US
Mailing Address - Phone:360-461-8921
Mailing Address - Fax:
Practice Address - Street 1:99 LISEL LN
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-7228
Practice Address - Country:US
Practice Address - Phone:360-461-8921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW610938961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical