Angela Denise Wisniewski, CO60451987

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CO60451987 Issued in WA

Practice address

2732 Grand Ave
Everett, WA 98201-3416

Phone

(425) 259-5842

Fax

(425) 259-0243

NPI assigned

Jan 18, 2018

Last updated

Jan 18, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516233600000",
    "number": "1023526555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 COLBY AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014022",
            "telephone_number": "425-259-5842",
            "fax_number": "425-259-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2732 GRAND AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013416",
            "telephone_number": "425-259-5842",
            "fax_number": "425-259-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "ANGELA",
        "middle_name": "DENISE",
        "credential": "CO60451987",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2018-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60451987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William M Wisbeck, M.D.
• Robert Wisdahl
• Lori Michelle Wisdom
• Kari D Wise, MA
• Michael A Wisler
• Jessica D Wissenbach, DO
• Elizabeth Lane Hulali Withey
• Witnessed Healing, PLLC
• Jonathan Witte, MD
• Kelly Nicole Wittemann, LMP

• Addiction (Substance Use Disorder) Counselor in Everett, WA
• Providers in Everett, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.