Individual
SHANNA LEE ANGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
521 ADAMS, MORTON, WA 98356
(360) 496-5112
(360) 496-3511
Mailing address
PO BOX 508, MOSSYROCK, WA 98564-0508
(360) 496-3702
(496) 983-3098
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30005616
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTH000
UNIVERSAL UPIN
WA
Enumeration date
08/23/2006
Last updated
07/08/2007
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