Healthcare Provider Details

I. General information

NPI: 1861319832
Provider Name (Legal Business Name): ANNA NOELLE PETERS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12900 NE 180TH ST STE 110
BOTHELL WA
98011-5773
US

IV. Provider business mailing address

12900 NE 180TH ST STE 110
BOTHELL WA
98011-5773
US

V. Phone/Fax

Practice location:
  • Phone: 425-483-4270
  • Fax: 888-497-3596
Mailing address:
  • Phone: 425-483-4270
  • Fax: 888-497-3596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT.PT.70131522
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: