Provider Demographics
NPI:1225001738
Name:LUND, ANGEL KAREN (MED, VRC)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:KAREN
Last Name:LUND
Suffix:
Gender:F
Credentials:MED, VRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1415
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:WA
Mailing Address - Zip Code:98812-1415
Mailing Address - Country:US
Mailing Address - Phone:509-689-0737
Mailing Address - Fax:
Practice Address - Street 1:767B PARADISE HILL RD
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:WA
Practice Address - Zip Code:98812-9517
Practice Address - Country:US
Practice Address - Phone:509-689-0737
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00028145101Y00000X
WA9630225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA181777OtherL&I PROVIDER NUMBER
WA181778OtherL&I PROVIDER NUMBER
WA8915404OtherCRIME VIC. PROVIDER NUMBE