Provider Demographics
NPI:1699031997
Name:HUGHES, ANGELA M (LMP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:HUGHES
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9714 CRAMER ROAD KP N
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98329-5798
Mailing Address - Country:US
Mailing Address - Phone:253-579-4071
Mailing Address - Fax:
Practice Address - Street 1:3211 56TH ST NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1359
Practice Address - Country:US
Practice Address - Phone:253-853-3434
Practice Address - Fax:253-851-5402
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60080226225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist