Provider Demographics
NPI:1497456180
Name:BISHOP, ANGIE LEE (RN)
Entity Type:Individual
Prefix:MS
First Name:ANGIE
Middle Name:LEE
Last Name:BISHOP
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:ANGELA
Other - Middle Name:LEE
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:2045 SILVERTON RD NE STE B
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-0100
Mailing Address - Country:US
Mailing Address - Phone:503-588-5351
Mailing Address - Fax:503-585-4908
Practice Address - Street 1:2045 SILVERTON RD NE STE B
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-0100
Practice Address - Country:US
Practice Address - Phone:503-588-5351
Practice Address - Fax:503-585-4908
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200940910RN163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult