Healthcare Provider Details

I. General information

NPI: 1265538557
Provider Name (Legal Business Name): ANNA MARIE OCASIONES TRONCALES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA MARIE LLAMIDO OCASIONES MD

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 01/18/2021
Certification Date: 01/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34503 9TH AVE S STE 100
FEDERAL WAY WA
98003-8726
US

IV. Provider business mailing address

34503 9TH AVE S STE 100
FEDERAL WAY WA
98003-8726
US

V. Phone/Fax

Practice location:
  • Phone: 253-835-8700
  • Fax: 206-244-3991
Mailing address:
  • Phone: 253-835-8700
  • Fax: 206-244-3991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD60630894
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberME108412
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: