Provider Demographics
NPI:1427370634
Name:ZUCHOWSKI, ANIYSA CARLIN (LMP)
Entity Type:Individual
Prefix:MRS
First Name:ANIYSA
Middle Name:CARLIN
Last Name:ZUCHOWSKI
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 1:1909 11TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-2506
Mailing Address - Country:US
Mailing Address - Phone:360-357-5170
Mailing Address - Fax:
Practice Address - Street 1:344 CLEVELAND AVE SE STE B
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501
Practice Address - Country:US
Practice Address - Phone:360-357-5170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-16
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist