Provider Demographics
NPI:1023551959
Name:HERMAN, ANNE WHEELER
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:WHEELER
Last Name:HERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46708 SE 129TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98045-8759
Mailing Address - Country:US
Mailing Address - Phone:206-261-0792
Mailing Address - Fax:
Practice Address - Street 1:46708 SE 129TH ST
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:WA
Practice Address - Zip Code:98045-8759
Practice Address - Country:US
Practice Address - Phone:206-261-0792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-26
Last Update Date:2016-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other