Healthcare Provider Details

I. General information

NPI: 1417381484
Provider Name (Legal Business Name): ANITA C HUFHAM RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANITA C UNDERWOOD

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 08/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3475 N SARATOGA ST
OAK HARBOR WA
98278-8800
US

IV. Provider business mailing address

4510 KINGSWAY
ANACORTES WA
98221-3206
US

V. Phone/Fax

Practice location:
  • Phone: 360-257-9500
  • Fax:
Mailing address:
  • Phone: 559-707-9988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number60216405
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number808885
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: