Healthcare Provider Details

I. General information

NPI: 1558332700
Provider Name (Legal Business Name): ANNA L LIEN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA L GREEN RN

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 01/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 TALBOT ROAD SOUTH SUITE 500
RENTON WA
98055-5791
US

IV. Provider business mailing address

PO BOX 59028
RENTON WA
98058-2028
US

V. Phone/Fax

Practice location:
  • Phone: 425-251-5110
  • Fax: 425-793-7380
Mailing address:
  • Phone: 425-251-5110
  • Fax: 425-793-4707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP30007141
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00140111
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: