Provider Demographics
NPI:1447346853
Name:EBELER-JONES, ANGELA (OD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:EBELER-JONES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:EBELER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:12310 NE 8TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3185
Mailing Address - Country:US
Mailing Address - Phone:425-455-0001
Mailing Address - Fax:425-453-3177
Practice Address - Street 1:12310 NE 8TH ST STE 101
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3185
Practice Address - Country:US
Practice Address - Phone:425-455-0001
Practice Address - Fax:425-453-3177
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00003569152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORU83096Medicare UPIN
OR108386Medicare ID - Type Unspecified