Provider Demographics
NPI:1255713145
Name:ANDERSON, ANNETTE (PMHNP-C, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PMHNP-C, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 NW MARKET ST STE 430B
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-4161
Mailing Address - Country:US
Mailing Address - Phone:206-844-7832
Mailing Address - Fax:206-466-5639
Practice Address - Street 1:2208 NW MARKET ST STE 430B
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4161
Practice Address - Country:US
Practice Address - Phone:206-844-7832
Practice Address - Fax:206-466-5639
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-26
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60567280363LF0000X
WAAP60567280363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty