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General NPI Number Information
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NPI Number | 1811238645
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Entity Type | Individual
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Provider Name | ANGELICA ELIZABETH ANDERSON PT
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Gender | Female
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Dates
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Enumeration Date | 03/04/2013
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Last Update Date | 06/14/2016
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Provider Practice Location Address
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Address Line | 1010 S 336TH ST SUITE 112
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City | FEDERAL WAY
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State | WA
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Zip | 98003-6385
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Country | US
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Telephone | 253-661-0041
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Fax | 253-661-0772
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Provider Business Mailing Address
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Address Line | 1010 S 336TH ST SUITE 112
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City | FEDERAL WAY
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State | WA
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Zip | 98003-6385
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Country | US
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Telephone | 253-661-0041
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Fax | 253-661-0772
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT60329481
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 10804
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License Number State | AZ
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