Provider Demographics
NPI:1396982864
Name:ADAMSKI, ANGELA LOUISE (LMT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:LOUISE
Last Name:ADAMSKI
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 1:3515 NE 90TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-5102
Mailing Address - Country:US
Mailing Address - Phone:206-276-0478
Mailing Address - Fax:
Practice Address - Street 1:200 NE 20TH AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-3094
Practice Address - Country:US
Practice Address - Phone:206-276-0478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-20
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15565225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist