Provider Demographics
NPI:1326564709
Name:POAGE, NANCI LOUISE
Entity Type:Individual
Prefix:
First Name:NANCI
Middle Name:LOUISE
Last Name:POAGE
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 1:2500 NW CASCADE AVE
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-3932
Mailing Address - Country:US
Mailing Address - Phone:509-393-1166
Mailing Address - Fax:
Practice Address - Street 1:470 9TH ST NE
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-7661
Practice Address - Country:US
Practice Address - Phone:509-393-1166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60779132171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist