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General NPI Number Information
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NPI Number | 1013830892
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Entity Type | Individual
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Provider Name | EKAETTE AMANDA ANGELL RN
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Gender | Female
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 5219 N SHIRLEY ST STE 4
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City | RUSTON
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State | WA
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Zip | 98407-6599
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Country | US
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Telephone | 253-200-1683
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Fax | 253-642-8590
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Provider Business Mailing Address
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Address Line | 3735 N VILLARD ST
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City | TACOMA
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State | WA
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Zip | 98407-3523
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Country | US
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Telephone | 253-200-1683
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Fax | 253-642-8590
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 9207117
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License Number State | FL
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