Active NPI
Angie L Dazell, R.N.
- Registered Nurse
- Shelton, WA
National Provider Identifier
1518399377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN00135147
- Practice address
- 361 E Way to Tipperary St
Shelton, WA 98584-7526 - Phone
- (360) 349-3570
- Fax
- (360) 358-8360
- NPI assigned
- Aug 4, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN00135147 | WA | Primary |
Addresses
Primary practice location
361 E Way to Tipperary St
Shelton, WA 98584-7526
Mailing address
361 E Way to Tipperary St
Shelton, WA 98584-7526
Phone (360) 349-3570
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN00135147 | WA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375574400000",
"number": "1518399377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "361 E WAY TO TIPPERARY ST",
"city": "SHELTON",
"state": "WA",
"postal_code": "985847526",
"telephone_number": "360-349-3570",
"fax_number": "360-358-8360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "361 E WAY TO TIPPERARY ST",
"city": "SHELTON",
"state": "WA",
"postal_code": "985847526",
"telephone_number": "360-349-3570",
"fax_number": "360-358-8360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAZELL",
"first_name": "ANGIE",
"middle_name": "L",
"credential": "R.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-04",
"last_updated": "2013-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN00135147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Shelton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.