Provider Demographics
NPI:1699764001
Name:ANGYAL, LUCINDA ANN (WHCNP)
Entity type:Individual
Prefix:MRS
First Name:LUCINDA
Middle Name:ANN
Last Name:ANGYAL
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 HILLWOOD CT S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-3621
Mailing Address - Country:US
Mailing Address - Phone:503-391-0433
Mailing Address - Fax:
Practice Address - Street 1:1305 CANNON ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-2548
Practice Address - Country:US
Practice Address - Phone:503-588-7525
Practice Address - Fax:503-588-7525
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR000031049N7363LW0102X
OR163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Not Answered163W00000XNursing Service ProvidersRegistered Nurse