Provider Demographics
NPI:1225037773
Name:STURM, ANNA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:
Last Name:STURM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3360
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3360
Mailing Address - Country:US
Mailing Address - Phone:866-366-2983
Mailing Address - Fax:
Practice Address - Street 1:1717 13TH ST
Practice Address - Street 2:SUITE 401
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-1621
Practice Address - Country:US
Practice Address - Phone:425-297-6400
Practice Address - Fax:425-297-6500
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001516363AM0700X
WAPA10005285363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPA10005285OtherWSL
WAPA10005285OtherWSL
WA8505687Medicaid
VAP76602Medicare UPIN
WA8870386Medicare PIN
VA144850OtherANTHEM MEDIGAP
VI010089921Medicaid