Provider Demographics
NPI:1497206338
Name:WOGAN, HILARY (MS,LF)
Entity Type:Individual
Prefix:
First Name:HILARY
Middle Name:
Last Name:WOGAN
Suffix:
Gender:F
Credentials:MS,LF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28109 101ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-8916
Mailing Address - Country:US
Mailing Address - Phone:206-999-0078
Mailing Address - Fax:206-463-6347
Practice Address - Street 1:21508 TRAMP HARBOR RD SW
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-6710
Practice Address - Country:US
Practice Address - Phone:206-999-0078
Practice Address - Fax:206-463-6347
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-15
Last Update Date:2016-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF 00002248106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist