Healthcare Provider Details

I. General information

NPI: 1760314249
Provider Name (Legal Business Name): ANISA YOUNG APRN-CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S COLUMBIAN WAY # 127
SEATTLE WA
98108-1532
US

IV. Provider business mailing address

1660 S COLUMBIAN WAY # 127
SEATTLE WA
98108-1532
US

V. Phone/Fax

Practice location:
  • Phone: 206-277-3777
  • Fax:
Mailing address:
  • Phone: 206-277-3777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License NumberARNP.AP.61044240-CNS
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: