Provider Demographics
NPI:1437307360
Name:VOGEL, JONATHAN J I
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:J
Last Name:VOGEL
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JONATHAN
Other - Middle Name:J
Other - Last Name:VOGEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MASSAGE THERAPIST
Mailing Address - Street 1:4204 SW OREGON ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-4236
Mailing Address - Country:US
Mailing Address - Phone:206-938-3175
Mailing Address - Fax:
Practice Address - Street 1:4204 SW OREGON ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4236
Practice Address - Country:US
Practice Address - Phone:206-938-3175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00003552172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist