Active NPI
Marissa E Ang, ATC
- Athletic Trainer
- Olympia, WA
National Provider Identifier
1013436484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2000030256
- Practice address
- 1110 Northcote St NW
Olympia, WA 98502-4457 - Phone
- (360) 888-0826
- NPI assigned
- Sep 16, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2000030256 | WA | Primary |
Addresses
Primary practice location
1110 Northcote St NW
Olympia, WA 98502-4457
Mailing address
1110 Northcote St NW
Olympia, WA 98502-4457
Phone (360) 888-0826
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000030256 | WA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1013436484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 NORTHCOTE ST NW",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985024457",
"telephone_number": "360-888-0826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 NORTHCOTE ST NW",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985024457",
"telephone_number": "360-888-0826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANG",
"first_name": "MARISSA",
"middle_name": "E",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-16",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WA",
"license": "2000030256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.