Provider Demographics
NPI:1326357260
Name:WORDEN, ANNA KALI (ARNP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:KALI
Last Name:WORDEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15214 CANYON RD E
Mailing Address - Street 2:STE 100
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375-7472
Mailing Address - Country:US
Mailing Address - Phone:253-539-4200
Mailing Address - Fax:253-539-6005
Practice Address - Street 1:15214 CANYON RD E
Practice Address - Street 2:STE 100
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98375-7472
Practice Address - Country:US
Practice Address - Phone:253-539-4200
Practice Address - Fax:253-539-6005
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60173002363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily