Provider Demographics
NPI:1801030549
Name:D'ANGELO, JEAN-PAUL H (LMT)
Entity Type:Individual
Prefix:MR
First Name:JEAN-PAUL
Middle Name:H
Last Name:D'ANGELO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 DOUGLASS AVE
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4539
Mailing Address - Country:US
Mailing Address - Phone:509-554-9366
Mailing Address - Fax:
Practice Address - Street 1:221 DOUGLASS AVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4539
Practice Address - Country:US
Practice Address - Phone:509-554-9366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-24
Last Update Date:2011-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60132890174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist