MEDICARE: ABIGAIL ANGELICA PAYNE LMP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP70049726	WA

General Provider Information

NPI Number	:	1912363797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL ANGELICA PAYNE LMP

Provider Business Mailing Address
First Line	:	8299 FAWN CRES
Second Line	:
City	:	BLAINE
State	:	WA
Zip	:	98230-9302
Country	:	US
Telephone Number	:	206-499-3758
Fax Number	:

Provider Business Practice Location Address
First Line	:	5700 172ND ST NE STE B
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-7742
Country	:	US
Telephone Number	:	360-572-3052
Fax Number	:	360-435-7941

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2016
Last Update Date	:	02/09/2026

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