Provider Demographics
NPI:1073366399
Name:BOTTEMILLER, ANNE KOUNTZ (HAS)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:KOUNTZ
Last Name:BOTTEMILLER
Suffix:
Gender:F
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11817 NE 142ND ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-1416
Mailing Address - Country:US
Mailing Address - Phone:425-281-3397
Mailing Address - Fax:
Practice Address - Street 1:1820 100TH PL SE STE A
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-3868
Practice Address - Country:US
Practice Address - Phone:425-337-9109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61484865237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist