Provider Demographics
NPI:1518212570
Name:AUTIO-MOWRER, ANGELA B (LMP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:B
Last Name:AUTIO-MOWRER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:
Other - Last Name:AUTIO-MOWRER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMP
Mailing Address - Street 1:820 NE NORTHGATE WAY
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-7312
Mailing Address - Country:US
Mailing Address - Phone:206-440-7700
Mailing Address - Fax:206-440-8900
Practice Address - Street 1:820 NE NORTHGATE WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-7312
Practice Address - Country:US
Practice Address - Phone:206-440-7700
Practice Address - Fax:206-440-8900
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60288076225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist