Provider Demographics
NPI:1346379765
Name:NUFFER, ROBERT (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:NUFFER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 STELLAR RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-7968
Mailing Address - Country:US
Mailing Address - Phone:360-477-3939
Mailing Address - Fax:360-683-5670
Practice Address - Street 1:9732 OLD OLYMPIC HWY
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3150
Practice Address - Country:US
Practice Address - Phone:360-477-3939
Practice Address - Fax:360-683-5670
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000084901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8857009Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER