Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | ||
N | 176B00000X | Midwife | 14020009 | |
Y | 176B00000X | Midwife | MW60452672 | WA |
NPI | 1023432028 |
---|---|
Provider Name | Crystal Ogle |
First Address | Clinton, WA 98236 |
Second Address | Clinton, WA 98236 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2014 |
Last Update Date | 25/11/2014 |