Provider Demographics
NPI:1508227802
Name:MAEDA, ANGELA (MAC, LMHC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MAEDA
Suffix:
Gender:F
Credentials:MAC, LMHC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:YU
Other - Last Name:YEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7616 116TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-8101
Mailing Address - Country:US
Mailing Address - Phone:206-774-8444
Mailing Address - Fax:
Practice Address - Street 1:7616 116TH AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-8101
Practice Address - Country:US
Practice Address - Phone:206-774-8444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60514883101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health