Healthcare Provider Details

I. General information

NPI: 1992109912
Provider Name (Legal Business Name): ANNE RENEE RILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2014
Last Update Date: 10/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3702 S FIFE ST STE B107
TACOMA WA
98409-7360
US

IV. Provider business mailing address

3702 S FIFE ST STE B107
TACOMA WA
98409-7360
US

V. Phone/Fax

Practice location:
  • Phone: 253-472-1693
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: