Provider Demographics
NPI:1619971991
Name:ANGEL, CRIS (MS, DA, AEMP, HDD)
Entity Type:Individual
Prefix:
First Name:CRIS
Middle Name:
Last Name:ANGEL
Suffix:
Gender:M
Credentials:MS, DA, AEMP, HDD
Other - Prefix:
Other - First Name:KRIS
Other - Middle Name:HARLYN
Other - Last Name:STOCKWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:914 164TH ST SE
Mailing Address - Street 2:SUITE B12 - 202
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012
Mailing Address - Country:US
Mailing Address - Phone:206-454-8224
Mailing Address - Fax:401-429-6150
Practice Address - Street 1:8229 44TH AVE W
Practice Address - Street 2:SUITE F
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275
Practice Address - Country:US
Practice Address - Phone:206-454-8224
Practice Address - Fax:401-429-6150
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-02
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALAC0000511171100000X
WAAC00000511171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist