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General NPI Number Information
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NPI Number | 1871399386
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Entity Type | Individual
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Provider Name | ANGELA KAY NELSON
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Gender | Female
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 20508 56TH AVE W
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City | LYNNWOOD
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State | WA
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Zip | 98036-7650
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Country | US
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Telephone | 425-678-1390
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Fax |
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Provider Business Mailing Address
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Address Line | 15404 218TH ST SE
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City | MONROE
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State | WA
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Zip | 98272-9162
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Country | US
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Telephone | 425-879-8431
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Fax |
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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 | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | RN60675511
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License Number State | WA
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