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General NPI Number Information
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NPI Number | 1629351317
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Entity Type | Individual
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Provider Name | ANNE ELIZABETH KOOMEN ARNP
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Gender | Female
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Dates
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Enumeration Date | 09/20/2011
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 1001 WATER ST
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City | PORT TOWNSEND
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State | WA
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Zip | 98368-6705
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Country | US
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Telephone | 154-847-4643
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1093
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City | PORT TOWNSEND
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State | WA
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Zip | 98368-1093
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Country | US
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Telephone | 415-847-4643
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP60298613
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 778674
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License Number State | CA
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