Provider Demographics
NPI:1023496668
Name:TIMBOL, ANNA (NP)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:TIMBOL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:LIZA
Other - Last Name:TIMBOL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:904 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1132
Mailing Address - Country:US
Mailing Address - Phone:206-560-4478
Mailing Address - Fax:206-860-5450
Practice Address - Street 1:904 7TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1132
Practice Address - Country:US
Practice Address - Phone:206-560-4478
Practice Address - Fax:206-860-5450
Is Sole Proprietor?:No
Enumeration Date:2015-05-15
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002440363LA2200X
WAAP60779722363LA2200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health