Provider Demographics
NPI:1275925406
Name:SKOGLEY, CRYSTAL
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:SKOGLEY
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 1:6508 FENWAY DR
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-8985
Mailing Address - Country:US
Mailing Address - Phone:509-845-0363
Mailing Address - Fax:
Practice Address - Street 1:1950 KEENE RD
Practice Address - Street 2:BLDG L
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-7751
Practice Address - Country:US
Practice Address - Phone:509-420-3442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor