Provider Demographics
NPI:1386144269
Name:ANGELES, ELAINE ROSS COSTALES (MSW)
Entity type:Individual
Prefix:
First Name:ELAINE ROSS
Middle Name:COSTALES
Last Name:ANGELES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 ALGONA BLVD S
Mailing Address - Street 2:
Mailing Address - City:ALGONA
Mailing Address - State:WA
Mailing Address - Zip Code:98001-8555
Mailing Address - Country:US
Mailing Address - Phone:253-678-2260
Mailing Address - Fax:
Practice Address - Street 1:1313 BROADWAY STE 200
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-3400
Practice Address - Country:US
Practice Address - Phone:253-301-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2024-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker