MEDICARE: DR. ANNE E. KIRK MD

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	207Q00000X	Family Medicine Physician	MD00043630	WA

General Provider Information

NPI Number	:	1912908427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNE E. KIRK MD

Provider Business Mailing Address
First Line	:	1019 39TH AVE SE
Second Line	:
City	:	PUYALLUP
State	:	WA
Zip	:	98374-2115
Country	:	US
Telephone Number	:	360-252-2500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1019 39TH AVE SE
Second Line	:
City	:	PUYALLUP
State	:	WA
Zip	:	98374-2115
Country	:	US
Telephone Number	:	360-252-2500
Fax Number	:

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	06/06/2016

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Directions to “ DR. ANNE E. KIRK MD” Practice Location

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