Healthcare Provider Details

I. General information

NPI: 1962926873
Provider Name (Legal Business Name): ANNA CHOWANIEC OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 NE PARK DR
ISSAQUAH WA
98029-7404
US

IV. Provider business mailing address

1000 NE PARK DR
ISSAQUAH WA
98029-7404
US

V. Phone/Fax

Practice location:
  • Phone: 425-391-3222
  • Fax: 425-657-3367
Mailing address:
  • Phone: 425-463-7684
  • Fax: 425-657-3367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOD61083464
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: