Healthcare Provider Details

I. General information

NPI: 1851360713
Provider Name (Legal Business Name): ANNE M PROUTY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3207 NW 64TH ST
SEATTLE WA
98107-2616
US

IV. Provider business mailing address

3207 NW 64TH ST
SEATTLE WA
98107-2616
US

V. Phone/Fax

Practice location:
  • Phone: 206-600-2663
  • Fax:
Mailing address:
  • Phone: 206-600-2663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberT1257
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF61103070
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: