Provider Demographics
NPI:1568444081
Name:HARMON GROUT, ANNE E
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:E
Last Name:HARMON GROUT
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 1:11304 8TH AVE NE
Mailing Address - Street 2:STE A
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6111
Mailing Address - Country:US
Mailing Address - Phone:206-363-6184
Mailing Address - Fax:206-363-6543
Practice Address - Street 1:11304 8TH AVE NE
Practice Address - Street 2:STE A
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6111
Practice Address - Country:US
Practice Address - Phone:206-363-6184
Practice Address - Fax:206-363-6543
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006408225100000X, 2251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAHA7545OtherREGENCE BLUE SHIELD
WA0126412OtherLABOR AND INDUSTRIES
651130OtherFIRST HEALTH