Provider Demographics
NPI:1164969267
Name:SNODGRASS, PAIGE
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:SNODGRASS
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:PO BOX 341
Mailing Address - Street 2:
Mailing Address - City:COSMOPOLIS
Mailing Address - State:WA
Mailing Address - Zip Code:98537-0341
Mailing Address - Country:US
Mailing Address - Phone:360-591-2246
Mailing Address - Fax:
Practice Address - Street 1:413 F ST
Practice Address - Street 2:
Practice Address - City:COSMOPOLIS
Practice Address - State:WA
Practice Address - Zip Code:98537
Practice Address - Country:US
Practice Address - Phone:360-593-3145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor