Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW60939330 | WA |
NPI | 1104483148 |
---|---|
Provider Name | Angela Dawn Lygren |
First Address | Seattle, WA 98125-4235 |
Second Address | Seattle, WA 98125-4235 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2019 |
Last Update Date | 24/05/2019 |