Angela Erdahl

Individual provider Active NPI Registered Nurse · Graham, WA

NPI 1114306164 · NPPES record last updated May 22, 2015

Key facts

NPI
1114306164
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
RN00172277 (WA)
Practice address
12102 294TH St E
Graham, WA 98338-9048
Phone
(253) 847-2012
NPI assigned
May 22, 2015
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RN00172277WAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Angela Erdahl, RN Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN00172277 WA Yes

Addresses

Primary practice location

12102 294TH St E
Graham, WA 98338-9048

Mailing address

12102 294TH St E
Graham, WA 98338-9048
Phone (253) 847-2012

Other providers in Graham, WA

All providers in Graham, WA · Registered Nurse in Washington

Sources for this page

Verify at the official NPI Registry.