Provider Demographics
NPI:1851911275
Name:ABELGAS, EVANGELINE (MT)
Entity Type:Individual
Prefix:
First Name:EVANGELINE
Middle Name:
Last Name:ABELGAS
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6826 20TH ST E UNIT 1
Mailing Address - Street 2:
Mailing Address - City:FIFE
Mailing Address - State:WA
Mailing Address - Zip Code:98424-3516
Mailing Address - Country:US
Mailing Address - Phone:415-410-6301
Mailing Address - Fax:
Practice Address - Street 1:6826 20TH ST E UNIT 1
Practice Address - Street 2:
Practice Address - City:FIFE
Practice Address - State:WA
Practice Address - Zip Code:98424-3516
Practice Address - Country:US
Practice Address - Phone:415-410-6301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMT-1176246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist