Healthcare Provider Details

I. General information

NPI: 1780127019
Provider Name (Legal Business Name): ANN L MINN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2016
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4919 EVERGREEN WAY
EVERETT WA
98203-2828
US

IV. Provider business mailing address

4919 EVERGREEN WAY
EVERETT WA
98203-2828
US

V. Phone/Fax

Practice location:
  • Phone: 425-259-3444
  • Fax: 425-339-2212
Mailing address:
  • Phone: 425-259-3444
  • Fax: 425-339-2212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH60666336
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: