Provider Demographics
NPI:1407879224
Name:SHOWALTER, ANITA LOUISE (DO)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:LOUISE
Last Name:SHOWALTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:ANITA
Other - Middle Name:LOUISE
Other - Last Name:HELMUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1006 S 64TH AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-2090
Mailing Address - Country:US
Mailing Address - Phone:509-517-5777
Mailing Address - Fax:509-317-9547
Practice Address - Street 1:1006 S 64TH AVE STE 120
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-2090
Practice Address - Country:US
Practice Address - Phone:509-517-5777
Practice Address - Fax:509-317-9547
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00002278207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHG73173Medicare UPIN