Provider Demographics
NPI:1063793875
Name:BOWEN, ANGELINA L (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:ANGELINA
Middle Name:L
Last Name:BOWEN
Suffix:
Gender:
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 687
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:WA
Mailing Address - Zip Code:98356-0687
Mailing Address - Country:US
Mailing Address - Phone:360-200-9749
Mailing Address - Fax:
Practice Address - Street 1:114 HIGH AVE
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:WA
Practice Address - Zip Code:98356-4000
Practice Address - Country:US
Practice Address - Phone:360-200-9749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF 60471382106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist