Provider Demographics
NPI:1962811190
Name:BARGANSKI, MISTY LYNN
Entity type:Individual
Prefix:
First Name:MISTY
Middle Name:LYNN
Last Name:BARGANSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3475 N SARATOGA ST
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98278-4927
Mailing Address - Country:US
Mailing Address - Phone:360-257-9972
Mailing Address - Fax:360-257-9978
Practice Address - Street 1:3475 N SARATOGA ST
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98278-4753
Practice Address - Country:US
Practice Address - Phone:360-257-9972
Practice Address - Fax:360-257-9978
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC605641501041C0700X
WALW611120921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical