Healthcare Provider Details

I. General information

NPI: 1740007582
Provider Name (Legal Business Name): ANNIE CAPPADONNA MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNIE SIMNACHER

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 SOUTHCENTER BLVD
TUKWILA WA
98188-2547
US

IV. Provider business mailing address

6400 SOUTHCENTER BLVD
TUKWILA WA
98188-2547
US

V. Phone/Fax

Practice location:
  • Phone: 206-901-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61652963
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: