Provider Demographics
NPI:1902861057
Name:YOUNGGREN, ANGELA CHRISTINE (MS LAC)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:CHRISTINE
Last Name:YOUNGGREN
Suffix:
Gender:F
Credentials:MS LAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 58009
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-1009
Mailing Address - Country:US
Mailing Address - Phone:425-235-4181
Mailing Address - Fax:425-277-3785
Practice Address - Street 1:19110 BOTHELL WAY NE
Practice Address - Street 2:#103
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-2970
Practice Address - Country:US
Practice Address - Phone:425-424-3588
Practice Address - Fax:425-424-0818
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC527171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist