Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | RC00028145 | WA |
N | 225C00000X | Rehabilitation Counselor | 9630 | WA |
NPI | 1225001738 |
---|---|
Provider Name | Angel Karen Lund |
First Address | Brewster, WA 98812-1415 |
Second Address | Brewster, WA 98812-9517 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
181777 | L&I PROVIDER NUMBER (01) | WA |
181778 | L&I PROVIDER NUMBER (01) | WA |
8915404 | CRIME VIC. PROVIDER NUMBE (01) | WA |