Provider Demographics
NPI:1699548321
Name:DEL ANGEL, CRISTAL (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:CRISTAL
Middle Name:
Last Name:DEL ANGEL
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17493 SW TURNING LEAF DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97003-7566
Mailing Address - Country:US
Mailing Address - Phone:503-381-1856
Mailing Address - Fax:
Practice Address - Street 1:15455 NW GREENBRIER PKWY STE 250
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-8116
Practice Address - Country:US
Practice Address - Phone:971-248-0068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR24676163WM1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)Group - Single Specialty