Provider Demographics
NPI:1114407129
Name:ATAEI, ANNA MARIA (DPT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIA
Last Name:ATAEI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:M
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10832 NE 68TH ST APT A6
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7189
Mailing Address - Country:US
Mailing Address - Phone:206-697-3545
Mailing Address - Fax:
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-744-2506
Practice Address - Fax:206-744-2642
Is Sole Proprietor?:No
Enumeration Date:2018-08-19
Last Update Date:2018-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60857260225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist