Provider Demographics
NPI:1417143256
Name:KOVSCEK, ANNASTASIA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNASTASIA
Middle Name:MARIE
Last Name:KOVSCEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1327
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260-1327
Mailing Address - Country:US
Mailing Address - Phone:360-221-1060
Mailing Address - Fax:360-221-1062
Practice Address - Street 1:221 2ND STREET
Practice Address - Street 2:#6A
Practice Address - City:LANGLEY
Practice Address - State:WA
Practice Address - Zip Code:98260
Practice Address - Country:US
Practice Address - Phone:369-221-1060
Practice Address - Fax:360-221-1062
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60091880207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine