Provider Demographics
NPI:1669288023
Name:MAGLIETTI, ANGELA LEE (LPN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:LEE
Last Name:MAGLIETTI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 S 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-4948
Mailing Address - Country:US
Mailing Address - Phone:509-949-5671
Mailing Address - Fax:
Practice Address - Street 1:104 N 4TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-2636
Practice Address - Country:US
Practice Address - Phone:509-573-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00038940164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse