Healthcare Provider Details

I. General information

NPI: 1013824879
Provider Name (Legal Business Name): ANNALIESE MARIE FROESE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 NEW GILMAN BLVD SUIT 105
ISSAQUAH WA
98027
US

IV. Provider business mailing address

425 VINE ST APT 420
SEATTLE WA
98121-1591
US

V. Phone/Fax

Practice location:
  • Phone: 425-313-0433
  • Fax:
Mailing address:
  • Phone: 231-715-6315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR.CH.70156211
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: