Healthcare Provider Details

I. General information

NPI: 1740769504
Provider Name (Legal Business Name): JAMES D PLOGER ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2018
Last Update Date: 08/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 JAMES ST
SEATTLE WA
98104-5102
US

IV. Provider business mailing address

1909 S CHARLES ST
SEATTLE WA
98144-2932
US

V. Phone/Fax

Practice location:
  • Phone: 206-372-4214
  • Fax:
Mailing address:
  • Phone: 206-372-4214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP60885870
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: