MEDICARE: ANNA POWELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PH60094001	WA
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	PH60094001	WA

General Provider Information

NPI Number	:	1043579634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA POWELL

Provider Business Mailing Address
First Line	:	4349 239TH PL SE
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98029-6438
Country	:	US
Telephone Number	:	206-334-4948
Fax Number	:

Provider Business Practice Location Address
First Line	:	1540 NW GILMAN BLVD
Second Line	:
City	:	ISSAQUAH
State	:	WA
Zip	:	98027-5309
Country	:	US
Telephone Number	:	425-392-7500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2012
Last Update Date	:	01/17/2020

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Directions to “ ANNA POWELL ” Practice Location

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