Provider Demographics
NPI:1265282545
Name:ANGELS PSYCHIATRY PLLC
Entity type:Organization
Organization Name:ANGELS PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHEW
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:425-229-8338
Mailing Address - Street 1:17220 127TH PL NE STE 304
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-7965
Mailing Address - Country:US
Mailing Address - Phone:425-229-8338
Mailing Address - Fax:480-680-1577
Practice Address - Street 1:17220 127TH PL NE STE 304
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-7965
Practice Address - Country:US
Practice Address - Phone:425-229-8338
Practice Address - Fax:480-680-1577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)