Provider Demographics
NPI:1033379037
Name:HAHN, ANNA MARIE (MED)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:MARIE
Last Name:HAHN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1458 FOWLER ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4717
Mailing Address - Country:US
Mailing Address - Phone:509-374-5391
Mailing Address - Fax:509-374-8743
Practice Address - Street 1:1458 FOWLER ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4717
Practice Address - Country:US
Practice Address - Phone:509-374-5391
Practice Address - Fax:509-374-8743
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010855101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH00010855OtherWA DEPARTMENT OF HEALTH