Provider Demographics
NPI:1215712088
Name:KLIPPENSTEIN, ANGEL D (NP)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:D
Last Name:KLIPPENSTEIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 PORT DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-6009
Mailing Address - Country:US
Mailing Address - Phone:208-298-0720
Mailing Address - Fax:208-298-0727
Practice Address - Street 1:808 PORT DR
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-6009
Practice Address - Country:US
Practice Address - Phone:208-298-0720
Practice Address - Fax:208-298-0727
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61464787363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner