Provider Demographics
NPI:1801224423
Name:ROSS, ANGELA (ND)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 CALIFORNIA AVE SW
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-1562
Mailing Address - Country:US
Mailing Address - Phone:206-400-7550
Mailing Address - Fax:206-400-7517
Practice Address - Street 1:5410 CALIFORNIA AVE SW
Practice Address - Street 2:SUITE 102
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136-1562
Practice Address - Country:US
Practice Address - Phone:206-400-7550
Practice Address - Fax:206-400-7517
Is Sole Proprietor?:No
Enumeration Date:2013-10-16
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60411969175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath