Provider Demographics
NPI:1427801299
Name:NAGELE, JACOB AARON
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:AARON
Last Name:NAGELE
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 1:1220 N HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2410
Mailing Address - Country:US
Mailing Address - Phone:509-505-4415
Mailing Address - Fax:509-621-2011
Practice Address - Street 1:1220 N HOWARD ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2410
Practice Address - Country:US
Practice Address - Phone:509-505-4415
Practice Address - Fax:509-621-2011
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor