Provider Demographics
NPI:1902137235
Name:SCHARRELMAN, ANGELA GENE (LMP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:GENE
Last Name:SCHARRELMAN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 NE EVERETT ST
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-1224
Mailing Address - Country:US
Mailing Address - Phone:360-833-9805
Mailing Address - Fax:
Practice Address - Street 1:1708 NE EVERETT ST
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-1224
Practice Address - Country:US
Practice Address - Phone:360-833-9805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60131593225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist