Angela Maria Lewis
Individual provider Active NPI Dental Assistant · JBLM, WA
NPI 1609387141 · NPPES record last updated Oct 23, 2017
Key facts
- NPI
- 1609387141
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Assistant 126800000X
- Practice address
- BLDG 11572 17TH & C St
JBLM, WA 98433 - Phone
- (253) 967-4989
- NPI assigned
- Oct 23, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | Yes |
Addresses
Primary practice location
BLDG 11572 17TH & C St
JBLM, WA 98433
Mailing address
Madigan Annex 9900
Tacoma, WA 98431-0001
Phone (253) 967-4989
Other providers in JBLM, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.