Provider Demographics
NPI:1629241310
Name:SAGLE, BOWIE K (LMHC)
Entity Type:Individual
Prefix:
First Name:BOWIE
Middle Name:K
Last Name:SAGLE
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 N PROCTOR ST # D
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98407-5228
Mailing Address - Country:US
Mailing Address - Phone:253-677-7119
Mailing Address - Fax:253-267-0258
Practice Address - Street 1:2702 N PROCTOR ST # D
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98407-5228
Practice Address - Country:US
Practice Address - Phone:253-677-7119
Practice Address - Fax:253-267-0258
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00008919101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health