Provider Demographics
NPI:1578701181
Name:WATSON, ANNA (LICSW)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:WATSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:TROMBLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2111 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-3318
Mailing Address - Country:US
Mailing Address - Phone:253-212-0750
Mailing Address - Fax:253-507-4613
Practice Address - Street 1:2111 N 30TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-3318
Practice Address - Country:US
Practice Address - Phone:253-212-0750
Practice Address - Fax:253-507-4613
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW603051181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical