Provider Demographics
NPI:1033182035
Name:FIELDS, ANGELA C (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:C
Last Name:FIELDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 S UNION AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1322
Mailing Address - Country:US
Mailing Address - Phone:253-272-8148
Mailing Address - Fax:253-404-0506
Practice Address - Street 1:2202 S CEDAR ST
Practice Address - Street 2:STE. 340
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2318
Practice Address - Country:US
Practice Address - Phone:253-503-2559
Practice Address - Fax:253-503-8513
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00042154207ZP0102X
AZ33799207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8357634Medicaid
WAP00033371Medicare PIN
WAG8861346Medicare PIN
WA001045700Medicare PIN
WA000188100Medicare PIN
WAAB37416Medicare PIN
WA8357634Medicaid