Provider Demographics
NPI:1407078249
Name:SLOTTEN, ANGELA-MARIE (LAC, CN)
Entity Type:Individual
Prefix:MS
First Name:ANGELA-MARIE
Middle Name:
Last Name:SLOTTEN
Suffix:
Gender:F
Credentials:LAC, CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 W MISSION AVE STE 248
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2345
Mailing Address - Country:US
Mailing Address - Phone:509-326-6654
Mailing Address - Fax:
Practice Address - Street 1:222 W MISSION AVE STE 248
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2345
Practice Address - Country:US
Practice Address - Phone:509-326-6654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2032171100000X
WANU00001501133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No133N00000XDietary & Nutritional Service ProvidersNutritionist