Provider Demographics
NPI:1104483148
Name:LYGREN, ANGELA DAWN (LM, CPM)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:DAWN
Last Name:LYGREN
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:DAWN
Other - Last Name:LYGREN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LM, CPM
Mailing Address - Street 1:3701 173RD PL SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-7536
Mailing Address - Country:US
Mailing Address - Phone:206-719-2409
Mailing Address - Fax:
Practice Address - Street 1:14700 NE 8TH ST STE 115
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-4115
Practice Address - Country:US
Practice Address - Phone:206-719-2409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-24
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW60939330176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife