Healthcare Provider Details

I. General information

NPI: 1598486953
Provider Name (Legal Business Name): ANNA CALLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2022
Last Update Date: 09/05/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE # 359775
SEATTLE WA
98104-2420
US

IV. Provider business mailing address

7918 S 116TH ST
SEATTLE WA
98178-3866
US

V. Phone/Fax

Practice location:
  • Phone: 206-774-2410
  • Fax:
Mailing address:
  • Phone: 512-783-7080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License NumberRN60784741
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: