Individual provider Active NPI

Angie L Dazell, R.N.

  • Registered Nurse
  • Shelton, WA
National Provider Identifier
1518399377
Registry record updated Aug 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN00135147 Issued in WA
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

Updated by the provider on Aug 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
RN00135147WAMDRegistered 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.

Verify at the official NPI Registry.