Healthcare Provider Details

I. General information

NPI: 1346379765
Provider Name (Legal Business Name): ROBERT NUFFER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 09/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9732 OLD OLYMPIC HWY
SEQUIM WA
98382-3150
US

IV. Provider business mailing address

445 STELLAR RIDGE LN
SEQUIM WA
98382-7968
US

V. Phone/Fax

Practice location:
  • Phone: 360-477-3939
  • Fax: 360-683-5670
Mailing address:
  • Phone: 360-477-3939
  • Fax: 360-683-5670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW00008490
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: