Basic Information
| Provider Information | |||||||||
| NPI: | 1497140206 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AGNEW | ||||||||
| FirstName: | ANGUS | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5215 | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984150215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2534038327 | ||||||||
| FaxNumber: | 2534031717 | ||||||||
| Practice Location | |||||||||
| Address1: | 315 M.L.K. JR. WAY | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2534021000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2015 | ||||||||
| LastUpdateDate: | 09/25/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD60835858 | WA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.