1174936082 NPI number — MS. ANNA M. MCLUEN M.D.

Table of content: MS. ANNA M. MCLUEN M.D. (NPI 1174936082)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174936082 NPI number — MS. ANNA M. MCLUEN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCLUEN
Provider First Name:
ANNA
Provider Middle Name:
M.
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCLUEN
Provider Other First Name:
ANNA
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1174936082
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1200 12TH AVE SOUTH
Provider Second Line Business Mailing Address:
SUITE 901
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98144
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-548-3114
Provider Business Mailing Address Fax Number:
206-762-6355

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1629 N 45TH ST
Provider Second Line Business Practice Location Address:
NEIGHBORECARE HEALTH
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-633-3350
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/09/2014

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: 207Q00000X , with the licence number:  MD60670368 , 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)