Provider Demographics
NPI:1386042539
Name:MASIN, ANNE MAGNIN
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MAGNIN
Last Name:MASIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12737 BEL RED RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2699
Mailing Address - Country:US
Mailing Address - Phone:425-269-3277
Mailing Address - Fax:
Practice Address - Street 1:12737 BEL RED RD
Practice Address - Street 2:SUITE 230
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2699
Practice Address - Country:US
Practice Address - Phone:425-269-3277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-19
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00011301101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health