Individual
CHARLENE R ANGELOSANTE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
8011 112TH STREET CT E, PUYALLUP, WA 98373-7814
(253) 848-0662
(253) 848-8567
Mailing address
9315 GRAVELLY LAKE DR SW, SUITE 203, LAKEWOOD, WA 98499-1574
(253) 581-5200
(253) 581-5203
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00011186
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
170980
LABOR & INDUSTRIES
WA
01
—
8930573
L&I CRIME VICTIMS PRGM
WA
01
—
AN7931
REGENCE BLUESHIELD
WA
Enumeration date
05/26/2006
Last updated
07/08/2007
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