Provider Demographics
NPI:1225342777
Name:ACHZIGER, ANNIE L (LMP)
Entity Type:Individual
Prefix:MS
First Name:ANNIE
Middle Name:L
Last Name:ACHZIGER
Suffix:
Gender:F
Credentials:LMP
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 1833
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-0099
Mailing Address - Country:US
Mailing Address - Phone:360-461-5468
Mailing Address - Fax:
Practice Address - Street 1:1147 LITTLE RIVER RD
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98363-9301
Practice Address - Country:US
Practice Address - Phone:360-461-5468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60110228225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist