Provider Demographics
NPI:1154729846
Name:OSBORNE, ANGELA (MA LMFTA)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:MA LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 N 33RD ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98407-6422
Mailing Address - Country:US
Mailing Address - Phone:253-370-6464
Mailing Address - Fax:
Practice Address - Street 1:6625 WAGNER WAY NW
Practice Address - Street 2:STE. 250
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-8392
Practice Address - Country:US
Practice Address - Phone:253-878-0365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-11
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist