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NPI Code Detail

MEDICARE: ANANGEL IRA CANLAS PA-C

MEDICARE: ANANGEL IRA CANLAS PA-C
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
1363A00000XPhysician AssistantPA70041136WA

General Provider Information

NPI Number : 1255213054
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANANGEL IRA CANLAS PA-C
Provider Business Mailing Address
First Line : 125 16TH AVE E
Second Line :
City : SEATTLE
State : WA
Zip : 98112-5211
Country : US
Telephone Number : 206-326-3000
Fax Number : 877-515-2975
Provider Business Practice Location Address
First Line : 125 16TH AVE E
Second Line :
City : SEATTLE
State : WA
Zip : 98112-5211
Country : US
Telephone Number : 206-326-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2025
Last Update Date : 01/06/2026

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