Provider Demographics
NPI:1043385016
Name:NEGRON FULTON, ANGELA N (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:N
Last Name:NEGRON FULTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:N
Other - Last Name:NEGRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:12911 120TH AVE NE STE G100
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3027
Mailing Address - Country:US
Mailing Address - Phone:425-899-4144
Mailing Address - Fax:425-899-4148
Practice Address - Street 1:12911 120TH AVE NE STE G100
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3027
Practice Address - Country:US
Practice Address - Phone:425-296-0260
Practice Address - Fax:425-899-4148
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10004950174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist