1982822128 NPI number — MS. ANITA Y CHAN CRNA

Table of content: MS. ANITA Y CHAN CRNA (NPI 1982822128)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982822128 NPI number — MS. ANITA Y CHAN CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAN
Provider First Name:
ANITA
Provider Middle Name:
Y
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982822128
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/17/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
201 16TH AVE E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98112-5226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-326-3000
Provider Business Mailing Address Fax Number:
206-326-2785

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 16TH AVE E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98112-5226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-326-3000
Provider Business Practice Location Address Fax Number:
206-326-2785
Provider Enumeration Date:
04/23/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  ARNP9187739 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X , with the licence number: AP60049960 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RNA0008 . This is a "ALASKA DSHS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".