Provider Demographics
NPI:1962047266
Name:NOGLER, JEFFREY OWEN (RECOVERY SPECIALIST)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:OWEN
Last Name:NOGLER
Suffix:
Gender:M
Credentials:RECOVERY SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 OLYMPIA AVE NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-4643
Mailing Address - Country:US
Mailing Address - Phone:360-529-1495
Mailing Address - Fax:
Practice Address - Street 1:1975 OLYMPIA AVE NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-4643
Practice Address - Country:US
Practice Address - Phone:360-529-1495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-10
Last Update Date:2019-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health