Provider Demographics
NPI:1093213548
Name:VARGAS, NAOMI (LSWAIC)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:
Other - Last Name:ESPULGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7605 ALICE CT SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503
Mailing Address - Country:US
Mailing Address - Phone:707-639-3789
Mailing Address - Fax:
Practice Address - Street 1:314 182ND AVE
Practice Address - Street 2:SUITE C
Practice Address - City:LAKE TAPPS
Practice Address - State:WA
Practice Address - Zip Code:98391
Practice Address - Country:US
Practice Address - Phone:253-501-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor