Provider Demographics
NPI:1245459171
Name:DOOLEY, ANGELA RENE (LMT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:RENE
Last Name:DOOLEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 VALLEY MALL PKWY # 607
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-4838
Mailing Address - Country:US
Mailing Address - Phone:509-433-8335
Mailing Address - Fax:
Practice Address - Street 1:206 2ND ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2101
Practice Address - Country:US
Practice Address - Phone:509-433-8335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2020-12-31
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2010-03-11
Provider Licenses
StateLicense IDTaxonomies
WAMA00020191225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist