Individual
ANGEL M FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDP-T
Contact information
Practice address
11000 LAKE CITY WAY NE, SEATTLE, WA 98125-6748
(206) 901-2000
(206) 901-2010
Mailing address
6400 SOUTHCENTER BLVD, TUKWILA, WA 98188-2547
(206) 901-2000
(206) 901-2010
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
61040159
WA
Other
Enumeration date
08/22/2022
Last updated
04/06/2026
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